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目的观察球后注射曲安奈德(TA)治疗不同类型视网膜静脉阻塞(RVO)所致黄斑水肿的临床疗效。设计同顾性病例系列。研究对象不同类型RVO继发黄斑水肿的患者21例21眼。方法患者均经球后注射TA 40mg,随访观察不同类型、不同病程RVO致黄斑水肿治疗前后的视力、眼压、荧光素眼底血管造影(FFA)和相干光断层扫描(OCT)检测黄斑水肿的变化情况。随访6～11个月。主要指标视力、黄斑中心凹平均厚度。结果到最后一次随访时,视力提高16眼(76.2%),视力不变5眼(23.8%)。治疗前及最后一次随访时黄斑中心凹平均厚度(617.23±185.58)μm、(287.55±121.70)μm(P=0.000)。治疗后CRVO组与BRVO组之间、缺血型组与非缺血型组之间,无论是视力还是黄斑中心凹平均厚度的变化的比较,差异均无明显统计学意义(P>0.05);病程≤3个月以及3～6个月的患者治疗前后的视力差异有统计学意义(P值分别为0.011,0.01),病程≥6个月的患者治疗前后的视力差异无明显统计学意义(P=0.583)。FFA显示治疗后黄斑区荧光素渗漏明显减轻。所有患者随访期间眼压均≤21mmHg。8例患者治疗后2～6个月黄斑水肿复发。结论球后注射TA可有效治疗RVO引起的黄斑水肿,操作简便且安全性高,早期治疗效果好。
Objective To observe the curative effect of retrobular injection of triamcinolone acetonide (TA) on macular edema induced by different types of retinal vein occlusion (RVO). Designed with the same type of cases of patients. 21 patients (21 eyes) with different types of secondary macular edema were included in the study. Methods All patients were followed up with 40 mg of TA for 40 days. The changes of macular edema before and after treatment of macular edema with different types and durations of RVO were observed. The visual acuity, intraocular pressure, fluorescein angiography (FFA) and coherence tomography (OCT) Happening. Follow-up 6 to 11 months. The main indicators of vision, macular foveal average thickness. Results At the last follow-up, visual acuity was improved by 16 eyes (76.2%) and visual acuity was unchanged by 5 eyes (23.8%). Mean foveal thickness (617.23 ± 185.58) μm, (287.55 ± 121.70) μm (P = 0.000) before and at last follow-up. There was no significant difference between the CRVO group and the BRVO group and between the ischemic group and the non - ischemic group in the changes of visual acuity or macular foveal thickness after treatment (P> 0.05). There were significant differences in visual acuity between before and after treatment (P = 0.011,0.01) and duration of disease≥6 months before and after treatment in patients with duration ≤3 months and 3-6 months P = 0.583). FFA showed significantly reduced macular fluorescein leakage after treatment. All patients underwent intraocular pressure during follow-up were ≤ 21mmHg. Eight patients had recurrence of macular edema 2 to 6 months after treatment. Conclusion Injection of TA can effectively treat RVO-induced macular edema after balloon injection. It is simple, safe, and effective in early treatment.