视网膜分支静脉阻塞合并黄斑水肿不同治疗方法的疗效观察

发布时间：2018-06-05 21:23

本文选题：视网膜分支静脉阻塞 + 黄斑水肿　；参考：《眼科新进展》2014年08期

【摘要】：目的通过对视网膜分支静脉阻塞(branch retinal vein occlusion,BRVO)在不同时期进行光凝及光凝联合玻璃体内注射曲安奈德治疗进行比较,探索治疗BRVO合并黄斑水肿更为有效的方法。方法 75例BRVO患者纳入研究,均为单眼。将所有患者分为5组,A组14例、病程为3~6个月,B组16例、病程3个月,以上两组入选后即行黄斑区局部格栅样光凝及颞上象限局部光凝治疗,C、D、E组均为入选后即行玻璃体内注射曲安奈德4 mg,注射后光凝时间分别为2周、4周、6周,每组15例。对比观察5组治疗前后最佳矫正视力(best corrected visual acuity,BCVA)、光学相干断层扫描(optical coherence tomography,OCT)、多焦视网膜电图(multifocal electroretinogram,mfERG)结果。结果 BCVA:5组中以C组BCVA改善最为显著,优于A、B、D、E组(均为P0.05)。OCT结果:C组最终黄斑中心凹厚度与A、B、D、E组相比,差异均有统计学意义(均为P0.05),D、E组均明显低于A、B组(均为P0.05)。mfERG结果:C、D、E各组黄斑区(即1、2环)P1、N1波振幅密度分别与A、B组比较明显增加,差异均有统计学意义(均为P0.05)。结论玻璃体内注射曲安奈德联合光凝治疗BRVO效果优于单纯激光治疗,玻璃体内注射曲安奈德2周后行激光光凝治疗效果最佳。
[Abstract]:Objective to compare the photocoagulation and photocoagulation combined with intravitreal injection of triamcinolone acetonide in the treatment of branch retinal vein occlusion branch retinal vein inclusion BRVO.To explore a more effective method for the treatment of BRVO with macular edema. Methods 75 patients with BRVO were included in the study. All the patients were divided into 5 groups: group A (n = 14) and group B (n = 16) with a course of 3 ~ 6 months. The above two groups were treated with macular area local grid photocoagulation and supratemporal quadrant local photocoagulation. All the two groups received intravitreal injection of triamcinolone acetonide (4 mg). The time of photocoagulation after injection was 2 weeks, 4 weeks and 6 weeks, respectively. 15 cases in each group were given intravitreal injection of triamcinolone acetonide. The best corrected visual acuity before and after treatment, optical coherence tomography (Oct) and multifocal electroretinogrammetry (mfERG) were compared. Results in BCVA:5 group, the improvement of BCVA in group C was the most significant, which was better than that in group E (P0.05).OCT results showed that the final foveal thickness of macular fovea in group C was higher than that in group A BX DX E). The difference was statistically significant (all P 0.05) and the amplitude density of N1 wave of P _ (1) P _ (1) N _ (1) P _ (1) N _ (1) were significantly higher than that of group A (P 0.05) (all P < 0.05). The results were as follows: (1) the amplitude density of P _ (1) P _ (1) N _ (1) wave was significantly higher in each group than that in group A (P < 0.05), and the difference was significant (P < 0.05). Conclusion the effect of intravitreal injection of triamcinolone acetonide combined with photocoagulation in the treatment of BRVO is better than that of laser alone. The best effect is the laser photocoagulation after 2 weeks of intravitreous injection of triamcinolone acetonide.
【作者单位】：沧州市中心医院眼一科;河北医科大学第二医院眼科;
【分类号】：R774

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