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目的观察玻璃体腔曲安奈德注射(intravitrealtriamcinoloneacetonide,IVTA)治疗视网膜分支静脉阻塞(branchretinalveinocclusion,BRVO)继发的黄斑水肿的近期疗效和安全性。方法对23例(23眼)BRVO继发的严重黄斑水肿患者,患眼行IVTA4mg/0.1ml,观察治疗前和治疗后1天、3天、1周、1个月、3个月时患者的最佳矫正视力、眼压、眼内炎性反应、晶体、眼底改变,光学相干断层扫描(opticcoherenttomography,OCT)测定黄斑区视网膜厚度变化。结果所有23眼中,有20眼(86.9%)视力提高,3眼(13.1%)视力不变。LogMAR视力治疗前为:0.75±0.48,治疗后一周、一个月、三个月时分别为:0.57±0.43;0.38±0.32;0.29±0.29。黄斑中心凹平均厚度治疗前为611±149μm,治疗后一周、一个月、三个月时分别为:325±129μm;208±55μm;173±38μm。治疗前后比较差异有统计学意义(P<0.01)。23眼中有3眼(13.1%)治疗后暂时性眼压轻度升高,经局部药物短期治疗后恢复正常。所有患眼未出现眼内炎、白内障、视网膜脱离、玻璃体出血等并发症。结论IVTA可以在短期内安全有效地治疗BRVO继发的黄斑水肿。
Objective To observe the short-term efficacy and safety of intravitreal triamcinolone acetonide (IVTA) in the treatment of macular edema secondary to retinal branch vein occlusion (BRVO). Methods Twenty-three patients (23 eyes) with severe macular edema secondary to BRVO were treated with IVTA 4 mg / 0.1 ml. The changes in the patients were observed before treatment and after 1 day, 3 days, 1 week, 1 month, 3 months after treatment The best corrected visual acuity, intraocular pressure, intraocular inflammatory reaction, crystal, fundus changes and optical coherence tomography (OCT) were used to measure the retinal thickness of the macula. Results In all 23 eyes, 20 eyes (86.9%) improved eyesight and 3 eyes (13.1%) had eyesight unchanged. LogMAR visual acuity before treatment: 0.75 ± 0.48, one week after treatment, one month, three months were: 0.57 ± 0.43; 0.38 ± 0.32; 0.29 ± 0.29. The mean foveal thickness of the fovea was 611 ± 149 μm before treatment, and one week, one month and three months after treatment were: 325 ± 129μm; 208 ± 55μm; 173 ± 38μm. Before and after treatment, the difference was statistically significant (P <0.01). There were 3 eyes (13.1%) in 23 eyes with slight increase of intraocular pressure after treatment, returned to normal after short-term local drug treatment. All eyes did not appear endophthalmitis, cataracts, retinal detachment, vitreous hemorrhage and other complications. Conclusion IVTA can safely and effectively treat macular edema secondary to BRVO in a short period of time.