激光联合曲安奈德治疗视网膜分支静脉阻塞性黄斑水肿的临床观察

摘要

目的：评价视网膜激光光凝联合玻璃体腔曲安奈德注射(IVTA)治疗视网膜分支静脉阻塞(BRVO)性黄斑水肿(ME)的疗效和安全性。方法：52例52眼BRVO性ME患者随机分为两组，联合组26例26眼IVTA(4 mg/0.1 ml)后1周行激光光凝，激光组26例26眼仅行激光光凝。随访6个月观察视力、眼底、黄斑水肿及并发症等。结果：治疗后1、3、6个月随访，两组患者治疗前后最佳矫正视力均提高，差异有统计学意义(P<0.05)，联合组视力优于激光组，差异有统计学意义(P<0.05)，黄斑中心凹厚度联合组低于激光组(P<0.05)，激光组并发症低于联合组(P<0.05)。结论：IVTA联合激光光凝是治疗BRVO性ME的有效方法，尤其是对于光凝治疗无效患者，但其长期疗效和安全性还需进一步观察。%Objective:To evaluate the efficacy and safety of treatment combined intravitreous injection Triamcinolone Acetonide(IVTA) with laser photocoagulation(LP) for branch retinal vein occlusion(BRVO) with maeular edema(ME).Method:Fifty-two patients(fifty-two eyes) with BRVO with ME were randomly divided into two groups,combination group:twenty-six eyes were treated with IVTA(4 mg/0.1 ml),and LP was used to treat all of the patients after one week.Laser group:twenty-six eyes were treated with LG.Best-corrected visual acuity(BCVA),central macular thinckness(CMT) and the incidence of complications were observed after the treatment.Result:For the different follow-up times at one month,three months,six months,BCVA and CMT of all patients improved after treatment,there were statistically significant differences between before treatment and after treatment in BCVA(P<0.05).Combination group was better than that of laser group(P>0.05).The CMT lowered in the combination group after treatment(P<0.05).The difference in the incidence of complications between the two groups showed a statistically significant difference(P<0.05).Conclusion:IVTA combined with LP can be an effective method in the treatment of DME,especially for patients which LP treatment is invalid,but its long-term efficacy and safety still need further observation.