曲安奈德联合格栅样光凝治疗糖尿病性黄斑水肿的临床观察

目的:评价曲安奈德(TA)联合黄斑区格栅样光凝(MLG)治疗糖尿病性黄斑水肿(DME)的疗效和安全性。方法:58例68眼的DME患者被分为2组,联合组30例34眼在玻璃体腔注射曲安奈德(IVTA)(4 mg/0.1mL)后1月行MLG,激光组28例34眼行单纯MLG。随访6个月观察视力、黄斑水肿情况及并发症。结果:两组患者治疗后1、3、6mo随访,患者最佳矫正视力提高、黄斑水肿减轻。最佳矫正视力治疗前后有统计学差异(P0.05),组间差异均无统计学意义(P0.05),黄斑中心凹厚度联合组低于激光组(P0.05),联合组所需激光能量低于激光组(P0.05),激光组并发症低于联合组(P0.05)。结论:IVTA联合MLG是治疗DME的有效方法,尤其是对于MLG治疗无效患者,但其长期疗效和安全性还需进一步观察。

Clinical study on effects of the combination of intravitreous injection Triamcinolone acetonide with macular laser grid photocoagulation in diabetic macular edema

0bjective To evaluate the efficacy and safety of treatment combined intravitreous injection triamcinolone acetonide（IVTA） with macular grid laser photocoagulation（MLG） for diabetic macular edema（DME）.Methods Fifty-eight patients（sixty-eight eyes） with DME were randomly divided into two groups： group A ：thirty four eyes were treated with IVTA（4 mg/ 0.1 mL）, and MLG was used to treat all of the patients after one month; group B： thirty four eyes were treated with MLG. Best-corrected visual acuity（BCVA）, central macular thinckness（CMT）and the incidence of complications were observed and measured after the treatment.Results For the different follow-up times at one month, three months, six months, BCVA and CMT of all patients improved after treatment. There were statistically significant differences between before treatment and after treatment in BCVA（P〈0.05）, but there was no statistically significant difference between the two groups（P〉0.05）. The CMT lowered in the group combined treatment after 3 months,6 months（P〈0.05）.The group combined treatment required lower laser energy than the group MLG（P〈0.05）,The difference in the incidence of complications between the two groups showed a statistically significant difference（P〈0.05）, MLG was safer. Conclusions IVTA combined with MLG can be an effective method in the treatment of DME, especially for patients which MLG treatment is invalid, but its long-term efficacy and safety still need further observation.