五种不同治疗视网膜中央静脉阻塞方法的视力预后

Visual outcomes in five different approaches for treatment of central retinal vein occlusion.

作者信息

Soheilian Masoud, Ramezani Alireza, Tavallali Ali, Mohebbi Mohammad R, Peyman Gholam A

机构信息

Ophthalmic Research Centre of Shaheed Beheshti Medical University, Labbafinejad Medical Centre, Tehran, Iran.

出版信息

Ophthalmic Surg Lasers Imaging. 2010 Mar-Apr;41(2):157-65. doi: 10.3928/15428877-20100303-02.

DOI:10.3928/15428877-20100303-02

PMID:20307032

Abstract

BACKGROUND AND OBJECTIVE

Four treatment methods for central retinal vein occlusion were compared with its natural course.

PATIENTS AND METHODS

In this partially prospective, comparative, interventional case series on 63 eyes with central retinal vein occlusion, five approaches were compared: intravitreal triamcinolone injection; radial optic neurotomy; combined radial optic neurotomy and intraocular triamcinolone injection; combined internal limiting membrane peeling, radial optic neurotomy, and intraocular triamcinolone; and observation.

RESULTS

Final visual acuity in the intravitreal triamcinolone group was better compared with the observation (P = .025), radial optic neurotomy (P = .037), combined radial optic neurotomy/intraocular triamcinolone injection (P = .401), and combined internal limiting membrane peeling, radial optic neurotomy, and intraocular triamcinolone injection (P = .023) groups. However, after adjustment for baseline visual acuity, the only treatment method with significant visual acuity improvement in relation to the observation group was the combined radial optic neurotomy/intraocular triamcinolone injection (P = .025, .023, and .054 at 1, 3, and 6 months, respectively).

CONCLUSION

Among the five different approaches analyzed in this study, combined radial optic neurotomy and intraocular triamcinolone injection may provide a better visual outcome in the management of central retinal vein occlusion.

摘要

背景与目的

比较视网膜中央静脉阻塞的四种治疗方法及其自然病程。

患者与方法

在这个对63例视网膜中央静脉阻塞患者眼睛进行的部分前瞻性、比较性、介入性病例系列研究中，比较了五种方法：玻璃体内注射曲安奈德；放射状视神经切开术；联合放射状视神经切开术与玻璃体内注射曲安奈德；联合内界膜剥除、放射状视神经切开术及玻璃体内注射曲安奈德；以及观察。

结果

玻璃体内注射曲安奈德组的最终视力与观察组（P = 0.025）、放射状视神经切开术组（P = 0.037）、联合放射状视神经切开术/玻璃体内注射曲安奈德组（P = 0.401）和联合内界膜剥除、放射状视神经切开术及玻璃体内注射曲安奈德组（P = 0.023）相比更好。然而，在对基线视力进行调整后，与观察组相比，唯一视力有显著改善的治疗方法是联合放射状视神经切开术/玻璃体内注射曲安奈德（分别在1、3和6个月时P = 0.025、0.023和0.054）。