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1、球后注射曲安奈德治疗视网膜分支静脉阻塞继发黄斑水肿作者：高云霞，刘方毅，赵军，王赞，王强【摘要】目的评价球后注射曲安奈徳(triamcinoloneacetonide,TA)治疗视网膜分支静脉阻塞(branchretinalveinocclusion,BRVO)继发黄斑水肿的有效安全性。方法对27例(31眼)RVO继发的严重黄斑水肿患者，患眼行球后注射曲安奈德40mg/lml,观察治疗前和治疗后1月、3月、6月时患者的最佳矫正视力、眼压、眼内炎性反应、晶体、眼底改变，光学相干断层扫描(opticalcoherenttomography,OCT)测定黄斑区视网膜厚度变化，FFA检
2、查眼底荧光造影改变。结果所有31眼中，有25眼(80.64%)视力提高，4眼(12.9%)视力不变，2眼复发行玻璃体腔内注射TA。视力治疗前为0.11±0.19,治疗后1月、3月、6月时分别为：0.36±0,32；0.56±0.28；0・65±0.35。黄斑中心凹平均厚度治疗前为582±139um,治疗后1月、3月、6月时分别为:329±119pm；207±58um；175土36um。治疗前后比较差异有统计学意义(P<0.05)o31眼中注射后1、3、6月分别有3眼(9.6%)、7眼(22.5%)和2眼(6.4%)眼压增高，经局部药物短期治疗后恢复正常。所有患眼未出现球后出血、
3、眼内炎、白内障、视网膜脱离等并发症。结论球后注射曲安奈徳可安全有效地治疗RRV0继发的黄斑水肿。【关键词】视网膜分支静脉阻塞曲安奈德黄斑水肿治疗ABSTRACTObjectiveToevaluatethesafeeffectofretrobulbarinjectionoftriaminoloneacetonide(TA)intreatingmacularedemasecondarytobranchretinalveinocclusion(BRVO).Methods31affectedeyesof27caseswithseriousmacularedemasecondarytoB
4、RVOreceivedretroblbarinjectionofTA,40mg/1ml;thebestcorrectedvision,introaocularpressure,inflammatoryreaction,crystalandfunduschangesofthepatientsbeforetreatmentandattheintervalsof1month,3monthsand6monthsaftertomography(OCT)wastreatmentwereobserved;opticalcoherentwasperformedto2caseswithreocc
5、urrence;theaveragevisionbeforetreatmentwas0.11±0.19andthatinthe1st,the3rdandthe6thmonthaftertreatmentwas0.36±0.32,0.56±0.28and0.65±0.35respectively;theaveragethicknessofmacularcentralfoveabeforetreatmentwas582+139umandthatinthe1st,the3rdandthe6thmonthaftertreatmentwas329+119uin,207+58umand17
6、5+36umrespectively;thedifferencewasofstatisticalsignificance(Pappliedtodetectthechangesofmacularretinalthickness,andfundusfluoresceinangiographywasmadeaswell.ResuItsOutofthe31eyes,25eyes(80.64%)hadvisionimprovementwhilethevisionsof4eyesremainedthesame,intravitrealinjectionofTA<0.05);theintro
7、aocularpressureof3eyes(9.6%)outofthe31eyesincreasedlmonthaftertheinjectionaswellas7eyes(22.5%)forashort3monthsaftertheinjectionand2eyes(6.4%)6monthsaftertheinjection,theyallbecamenormalafterlocaldrugadministrationtime;nosuchcomplicationsasretrobulb
