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目的探讨玻璃体腔二次注射曲安奈德治疗渗出型年龄相关性黄斑变性继发黄斑水肿的疗效和安全性。方法治疗组在首次玻璃体腔注射曲安奈德平均4.1个月后2次注射。对照组玻璃体腔只注射1次曲安奈德,2组注射剂量均为20mg,并辅助维生素类、烟酸酯、银杏叶片及甲钴胺片等口服。用药后平均随访6个月,对比观察用药前后的视力、眼压、晶状体及眼底改变以及光学相干断层扫描(OCT)检测的黄斑区视网膜厚度变化。结果治疗组视力平均提高0.29±0.17,对照组视力平均提高0.16±0.13,2组差异有统计学意义(t=4.734,P<0.05),OCT检查显示治疗组与对照组差异有统计学意义(t=5.842,P<0.01)。9只眼眼压高于21mmHg,占17%。眼压升高多发生于用药后1周至2个月,经局部用β受体阻滞剂眼压均能控制正常,3只眼白内障发展。结论渗出型年龄相关性黄斑变性继发黄斑水肿经过二次玻璃体腔注射曲安奈德后能够产生良好的疗效,一过性眼压升高是最常见的不良反应,但目前尚不能肯定是否能够无限次的注射。
Objective To investigate the efficacy and safety of intravitreous injection of triamcinolone acetonide in the treatment of secondary macular edema in exudative age-related macular degeneration. Methods The treatment group was injected twice with triamcinolone acetonide 4.1 months after the first intravitreal injection of triamcinolone acetonide. Vitreous cavity of the control group was injected with triamcinolone acetonide once only. Both groups were injected with 20 mg of vitamin A, nicotinic acid ester, ginkgo leaf and methylcobalamin tablets orally. The patients were followed up for an average of 6 months after treatment. Changes of visual acuity, intraocular pressure, changes of lens and fundus, and changes of macular retinal thickness detected by optical coherence tomography (OCT) before and after treatment were observed. Results The mean visual acuity of the treatment group increased by 0.29 ± 0.17 and that of the control group increased by 0.16 ± 0.13 (t = 4.734, P <0.05). The OCT examination showed that the difference between the treatment group and the control group was statistically significant (t = t = 5.842, P <0.01). Nine ocular hypertension was higher than 21mmHg, accounting for 17%. Intraocular pressure increased occurred in 1 week to 2 months after treatment, by local use of β-blocker intraocular pressure can be controlled normal, 3 eyes cataract development. Conclusion Exudative age-related macular degeneration secondary macular edema after intravitreal injection of triamcinolone acetonide can produce good effect, transient elevated intraocular pressure is the most common adverse reactions, but it is not sure whether it can Infinite injections.