孙 笑，郝 义，温 良，丁晓霞

·临床报告·

曲安奈德眼内注射联合格栅样光凝治疗视网膜静脉阻塞黄斑囊样水肿短期疗效观察

孙 笑，郝 义，温 良，丁晓霞

FushunOphthalmopathyHospital，Fushun113008，Liaoning Province，China

Correspondence to:Xiao Sun.Fushun Ophthalmopathy Hospital，Fushun 113008，Liaoning Province，China.smile-le@163.com

·AIM:Toevaluatetheefficacyofintravitreal triamcinolone acetonideinjectioncombinedwithgrid pattern photocoagulation for macular edema secondary to retinal vein occlusion.

·METHODS:Forty patients（40eyes）with cystoid macular edema secondary to retinal vein occlusion were enrolled.In the treatment group，20 cases（20 eyes）were treated with intravitreal injection of 2mg triamcinolone acetonide，then grid pattern photocoagulation for macular area at 1wk after the injection.Another 20 patients（20 eyes）in control group were treated with intravitreal injection of 2mg triamcinolone acetonide only.Macular retinal thickness was measured by OCT before and after treatments toanalyzetheabsorptionofthecystoid macular edema and the improvement of visual acuity.

·RESULTS:Themeanmacularretinalthicknessof treatment group before treatments was 412.67±133.04μm. At 3mo after treatments macular retinal thickness was 281.63±59.39μm.The mean macular retinal thickness of control group before treatments was 409.58±131.96μm，and at 3mo after treatments macular retinal thickness was 358.72±116.17μm.There was a significant difference between the two group on mean macular retinal thickness after treatments（t=8.97，P=0.003＜0.05）.After 3mo of treatments，cystoidmacularedemareappearedin4 patientsandrepeatedintraocularinjectionof triamcinolone acetonide was given.In the control group，12 cases had recurrent macular edema and were given repeated intraocular injection of triamcinolone acetonide. With Chi-square test，there was a significant difference between the two groups on the recurrence rate（χ2=6.50，P= 0.022＜0.05）.

·CONCLUSION:Combinedtherapyofintravitreal injection of triamcinolone acetonide and gridpattern photocoagulation in macular area for cystoid macular edema secondary to retinal vein occlusion is effective，and the visual acuity improve significantly with fewer relapses.

目的：观察曲安奈德玻璃体腔注射联合黄斑区格栅样光凝治疗视网膜静脉阻塞黄斑囊样水肿的效果。

方法：视网膜静脉阻塞合并黄斑囊样水肿的患者40例40眼，其中治疗组20例20眼给予曲安奈德2mg玻璃体腔注射，1wk后行黄斑区格栅样光凝治疗；另外对照组20例20眼行单纯曲安奈德2mg眼内注射。通过OCT测量黄斑区视网膜的厚度以分析治疗前后黄斑囊样水肿的吸收情况和视力的改善情况。

结果：治疗组患者治疗前黄斑区视网膜平均厚度为412.67±133.04μm，治疗后3mo为281.63±59.39μm；对照组治疗前黄斑区视网膜的平均厚度为409.58±131.96μm，治疗后3mo为358.72±116.17μm，治疗后两组患者间黄斑区的视网膜厚度变化差异有统计学意义（t=8.97，P= 0.003＜0.05）。治疗组3mo后有4眼患者黄斑囊样水肿复发，再次行曲安奈德眼内注射；对照组3mo后有12眼黄斑水肿复发，再次行眼内曲安奈德注射治疗。卡方检验比较两组患者间复发病例，差异有统计学意义（χ2=6.50，P= 0.022＜0.05）。

结论：曲安奈德玻璃体腔注射联合黄斑区格栅样光凝治疗静脉阻塞黄斑囊样水肿疗效显著，患者视力有所提高，并且较少复发。

曲安奈德；格栅样光凝；黄斑囊样水肿；视网膜静脉阻塞

引用：孙笑，郝义，温良，等.曲安奈德眼内注射联合格栅样光凝治疗视网膜静脉阻塞黄斑囊样水肿短期疗效观察.国际眼科杂志2016；16（3）:552-554

0　引言

黄斑区囊样水肿是视网膜静脉阻塞导致患者视力下降、视功能严重受损的主要并发症，由于患者的黄斑水肿通常较重，视网膜增厚明显，单纯的格栅样光凝很少能形成有效光斑，疗效较差。……