后Tenon囊下注射曲安奈德治疗黄斑水肿对眼压的影响

目的：研究后Tenon囊下注射20mg曲安奈德（TA）治疗黄斑水肿后的眼压变化及眼压升高的影响因素。方法：黄斑水肿患者46例46眼,病因为糖尿病性视网膜病变16例,年龄相关性黄斑变性13例,视网膜静脉栓塞11例,后葡萄膜炎6例,均行后Tenon囊下注射20mgTA。注射前测量眼压,并于注射后2wk;1,2,3,4,5,6mo随访观察眼压变化。结果：患者46例术后2wk;1,2,3,4,5,6mo平均眼压较术前均有升高。术后3mo时,平均眼压达最高值（19.22±6.86）mmHg,有17例（37%）患者IOP〉21mmHg。术后2wk;1,2,3,4,5mo眼压与术前比较,差别有统计学意义（值分别为3.747,5.836,5.982,5.866,4.202,3.246,均P〈0.05）,术后6mo眼压与术前比较,差别无统计学意义（t=1.446,P〉0.05）。年轻、基础眼压高是后Tenon囊下注射曲安奈德后继发性眼压升高的危险因素（χ2值分别为5.599,10.323,均P〈0.05）,而性别、病因与后Tenon囊下注射曲安奈德后继发性眼压升高没有相关性（χ2值分别为0.022,0.050,均P〉0.05）。结论：后Tenon囊下注射20mg曲安奈德,引起眼压升高较为常见,在注射后3mo时眼压升高最为明显,注射后6mo时回落至基础眼压水平。年轻、基础眼压高是继发性眼压升高的危险因素。注射后进行最短为期6mo的眼压随访是非常必要的,尤其是对于年轻患者及基础眼压高的患者。

Changes of intraocular pressure after posterior sub-Tenon's capsule injection with triamcinolone acetonide for macular edema

AIM:To investigate the changes of intraocular pressure (IOP) and associated factors of IOP elevation after posterior sub-Tenon’s capsule (PST) injection with triamcinolone acetonide (TA) for macular edema. METHODS:The study included 46 cases(46 eyes) who received PST injections of 20mg TA to treat macular edema with diabetic retinopathy (n=16),age-related macular degeneration (n=13), retinal vein occlusion (n=11),and posterior uveitis (n=6). IOP measurements were performed on the day of injection, and 2 weeks,1 month,2, 3, 4, 5 and 6 months later. RESULTS:The mean IOP of all eyes showed a gradual increase after the injection, peaked at 3 months (19.22±6.86mmHg), and then decreased gradually until reaching a minimum at 6 months. Of the 46 eyes, 17(37%) showed an IOP above 21 mmHg at 3 months post-injection. Compared with the pre-injection, the mean IOP increased significantly at 2 weeks,1 month,2,3,4,5 months(t value were 3.747, 5.836, 5.982, 5.866, 4.202, 3.246 respectively, all P<0.05), however, there was no significant difference between the pre-injection and the 6 months post-injection (t=1.446,P>0.05) . And IOP elevation significantly correlated with younger age(χ2=5.599,P<0.05)and higher baseline IOP(χ2=10.323,P<0.05), but not with gender(χ2=0.022,P>0.05)or disease(χ2=0.050,P>0.05). CONCLUSION:E1evation of IOP after PST injection with TA is not rare and the peak level usually occurs at 3 months post-injection, and then the IOP decreases gradually to approach the baseline level until 6 months post-injection. Younger age and higher baseline IOP are identified as risk factors. Our findings indicate that careful assessment of IOP during a follow-up at least 6 months is necessary,especially in those who are younger or with higher baseline IOP.