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玻璃体切除术后眼内或腱膜下曲安奈德注射对增殖性糖尿病性视网膜病变眼周边视网膜脉络膜厚度的影响。

Effect of intravitreal or sub-tenon triamcinolone acetonide injection at completion of vitrectomy on peripheral retinochoroidal thickness in eyes with proliferative diabetic retinopathy.

机构信息

Department of Ophthalmology, Nagoya University Hospital, Nagoya, Japan.

出版信息

Sci Rep. 2019 Jan 17;9(1):171. doi: 10.1038/s41598-018-37220-3.

Abstract

The effect of triamcinolone acetonide (TA) on the peripheral retinochoroidal thickness was determined after pars plana vitrectomy (PPV) with scatter photocoagulation in eyes with proliferative diabetic retinopathy. The peripheral retinochoroidal thickness was measured at 5 mm from the limbus in the four quadrants using anterior segment optical coherence tomography before, and 3 days, and 1 and 2 weeks after the surgery. The total peripheral thickness was significantly thicker than the baseline thickness after PPV alone (P < 0.001; 18 eyes), PPV combined with intravitreal TA injection (IVTA; P = 0.011; 19 eyes), and PPV combined with sub-tenon TA injection (STTA; P = 0001; 23 eyes). The total peripheral thickness in the PPV group at 3 days after surgery was significantly thicker than that of the PPV + IVTA (P = 0.015) and of the PPV + STTA groups (P = 0.016). Multiple linear regression analyses showed that the injection of TA by the two routes and the number of photocoagulation burns were significantly correlated with the total peripheral thicknesses at 3 days after the surgery. The results indicate that the PPV with large number of intraoperative scatter photocoagulation burns caused an increase in the total peripheral thickness and an administration of either IVTA and STTA can reduced the degree of thickening.

摘要

曲安奈德(TA)对增生性糖尿病视网膜病变患者行玻璃体切除术(PPV)联合散斑光凝术后周边视网膜脉络膜厚度的影响。采用前节光学相干断层扫描(AS-OCT),于距角膜缘 5mm 的四个象限测量周边视网膜脉络膜厚度,分别于术前、术后 3 天、1 周和 2 周进行测量。与单纯 PPV 组(P<0.001;18 眼)、PPV 联合玻璃体内曲安奈德注射组(IVTA;P=0.011;19 眼)和 PPV 联合球后曲安奈德注射组(STTA;P=0.0001;23 眼)相比,PPV 后总周边厚度明显增厚。术后 3 天,PPV 组总周边厚度明显高于 PPV+IVTA 组(P=0.015)和 PPV+STTA 组(P=0.016)。多元线性回归分析显示,两种途径注射 TA 以及术中散斑光凝的次数与术后 3 天总周边厚度显著相关。结果表明,术中大量散斑光凝可导致总周边厚度增加,玻璃体内和球后注射 TA 均可减轻增厚程度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/796b/6336773/d88e0abf57f1/41598_2018_37220_Fig1_HTML.jpg

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