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目的:研究玻璃体腔注射4mg曲安奈德(IVTA)治疗黄斑水肿后的眼压(IOP)变化及其相关因素。方法:本研究为回顾性、连续性及非对照病例序列研究。包括93眼黄斑水肿患者,病因分别为视网膜静脉阻塞(54眼)和糖尿病视网膜病变(39眼),都接受了4mgIVTA注射。所有病例均在注射前和注射后14d,1,2,3,4,5,6mo随访眼压变化。并分析基础IOP,病因,年龄和性别与眼压的相关性。结果:注射后14dIOP显著升高(16.02±2.45mmHg,P<0.001),注射后2mo达到高峰(18.80±6.20mmHg,P<0.001)。注射后14d有2眼眼压超高21mmHg(2.2%),术后1,2,3,4,5,6mo分别是14(15.1%),18(19.5%),9(9.6%),4(4.3%),0,0。注射后14d有1眼(0.01%)眼压较基础眼压升高超过5mmHg,术后2mo达到高峰,为22眼(23.7%)。注射后1mo有5眼(5.3%)眼压升高10mmHg,2mo最高为12眼(12.9%)。IOP升高和年龄(相关系数-0.18～-0.29,P<0.05),基础眼压(相关系数0.52～0.79,P<0.001)及糖尿病(相关系数0.23,P<0.001)显著相关,但与性别无相关性(相关系数-0.002～0.04,P>0.05)。所有患眼的IOP均能通过局部降眼压药物控制到正常,没有1例发生青光眼性视神经病变。结论:4mgIVTA注射后眼压升高是很普遍的现象,注射后应该至少随访观察6mo以上。所有患眼的高眼压均能通过局部降眼压药物得到控制。对于基础眼压较高,糖尿病视网膜病变及年轻患者更应该关注注射后的眼压变化。
Objective: To investigate the changes of intraocular pressure (IOP) and its related factors after intravitreal injection of 4mg triamcinolone acetonide (IVTA) in the treatment of macular edema. Methods: This study was a retrospective, continuous and uncontrolled case series study. Including 93 patients with macular edema, the etiology was retinal vein occlusion (54 eyes) and diabetic retinopathy (39 eyes), both receiving 4 mg IVTA injections. All cases were in before injection and after injection 14d, 1,2,3,4,5,6mo follow-up intraocular pressure changes. And analyzed the underlying IOP, etiology, age and gender and intraocular pressure related. Results: The IOP at 14th day after injection was significantly higher (16.02 ± 2.45mmHg, P <0.001) and peaked at 2mo after injection (18.80 ± 6.20mmHg, P <0.001). At 14 days after injection, 2 eyes had an intraocular pressure of 21 mmHg (2.2%) and 14 (15.1%), 18 (19.5%), 9 (9.6% (4.3%), 0,0. One eye (0.01%) intraocular pressure (IOP) increased more than 5mmHg at baseline 14 days after injection and 22 eyes (23.7%) at 2 months postoperatively. At 1 month after injection, 5 eyes (5.3%) had a 10 mmHg increase in intraocular pressure and a maximum of 12 eyes (12.9%) in 2 months. IOP was significantly correlated with age (correlation coefficient -0.18-0.29, P <0.05), IOP (correlation coefficient 0.52-0.79, P <0.001) and diabetes mellitus (correlation coefficient 0.23, P <0.001) No correlation (correlation coefficient -0.002 ~ 0.04, P> 0.05). IOP in all affected eyes was controlled by local IOP lowering drugs and no one had glaucomatous optic neuropathy. CONCLUSIONS: Intraocular pressure (IOP) elevation after 4 mgIVTA injection is a common occurrence and should be followed for at least 6 months after injection. All ocular hypertension can be controlled by the local intraocular pressure lowering drugs. For the higher intraocular pressure, diabetic retinopathy and young patients should pay more attention to changes in intraocular pressure after injection.