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单纯玻璃体切除术与玻璃体切除术联合玻璃体内注射曲安奈德治疗视网膜分支静脉阻塞相关黄斑水肿的对比研究

Vitrectomy alone versus vitrectomy with simultaneous intravitreal injection of triamcinolone for macular edema associated with branch retinal vein occlusion.

作者信息

Uemura Akihiro, Yamamoto Shuichi, Sato Eiju, Sugawara Takeshi, Mitamura Yoshinori, Mizunoya Satoshi

机构信息

Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, Japan.

出版信息

Ophthalmic Surg Lasers Imaging. 2009 Jan-Feb;40(1):6-12. doi: 10.3928/15428877-20090101-19.

Abstract

BACKGROUND AND OBJECTIVE

To evaluate the efficacy of vitrectomy with simultaneous intravitreal injection of triamcinolone acetonide for macular edema associated with branch retinal vein occlusion.

PATIENTS AND METHODS

A retrospective study of 45 eyes with macular edema associated with branch retinal vein occlusion. A posterior vitreous detachment was created and the vitreous cortex was completely removed, after which 23 eyes immediately had an intravitreal injection of triamcinolone acetonide (triamcinolone acetonide group) and 22 eyes did not (no triamcinolone acetonide group). Visual acuity, fluorescein angiograms, and foveal thickness determined by optical coherence tomography were examined preoperatively and postoperatively.

RESULTS

Mean postoperative visual acuity at 12 months was significantly better than the preoperative visual acuity in both groups. The fovea was significantly thinner 1 month postoperatively in both groups. Foveal thickness gradually decreased until 12 months in the no triamcinolone acetonide group; however, foveal thickness increased for 12 months in the triamcinolone acetonide group. A recurrence of macular edema was more frequent in the triamcinolone acetonide group than in the no triamcinolone acetonide group (P = .006).

CONCLUSIONS

Because there was no significant difference in the improvement of best-corrected visual acuity between the groups 12 months postoperatively, there may be no benefit in the use of intraoperative intravitreal triamcinolone acetonide.

摘要

背景与目的

评估玻璃体切除术联合玻璃体内注射曲安奈德治疗视网膜分支静脉阻塞相关黄斑水肿的疗效。

患者与方法

对45例视网膜分支静脉阻塞相关黄斑水肿患者的眼部进行回顾性研究。造成玻璃体后脱离并完全清除玻璃体皮质,之后23只眼立即接受玻璃体内注射曲安奈德(曲安奈德组),22只眼未接受注射(非曲安奈德组)。术前及术后检查视力、荧光素血管造影以及通过光学相干断层扫描测定的黄斑中心凹厚度。

结果

两组术后12个月时的平均视力均显著优于术前视力。两组术后1个月时黄斑中心凹均显著变薄。非曲安奈德组黄斑中心凹厚度直至12个月时逐渐降低;然而,曲安奈德组黄斑中心凹厚度在12个月内持续增加。曲安奈德组黄斑水肿复发比非曲安奈德组更频繁(P = 0.006)。

结论

由于术后12个月时两组间最佳矫正视力改善情况无显著差异,术中使用玻璃体内曲安奈德可能并无益处。

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