Objective To observe the clinical effect of Fundus Laser combined with Anisodine and Triamcinolone acetonide in the treatment of ischemic retinal vein occlusion.Methods Prospective cases series.90 patients (90 eyes) with ischemic retinal vein occlusion from January 2014 to October 2015 in Tongren hospital were included into the present study.All the patients were randomly divided intoⅠ, Ⅱ, Ⅲgroup, and treated with retinal laser photocoagulation (PRP) for 4 times, once a week, Ⅰgroup were injected 1 ml (40 mg) beside ipsilateral eye for 2 times, Each 2wk injection once.Ⅱgroup were treated with 2ml Triamcinolone acetonide by superficial temporal artery Subcutaneous injection for 30d,qd.Ⅲgroup was treated with Anisodine and Triamcinolone acetonide.Before and after treatment, the best corrected visual acuity (BCVA) was measured by EDTRS visual acuity chart.The central macular thickness (CMT) was examined by optical coherence tomography (OCT).The hemodynamic parameters of the central retinal artery were detected by color Doppler ultrasonography.The effect of visual acuity were evaluated.Results The effect of visual of Ⅲgroup was significantly higher than that of Ⅰgroup andⅡgroup (p<0.05).In group Ⅲ, BCVA was significantly higher than that in group Ⅰ, Ⅱ(p<0.05), and CMT was significantly lower than that in group Ⅰand Ⅱ(p<0.05).The peak systolic velocity (PSV) and end diastolic velocity (EDV) of the central retinal artery (CRA) in Ⅲgroup were significantly higher than those in group Ⅰand group Ⅱ(p<0.05).The resistance index (RI), maximal flow velocity (Vmax) and minimum flow velocity (Vmin) of the central retinal vein (CRV) were significantly higher than those in group Ⅰand group Ⅱ (p<0.05), the Vmax and Vmin of CRV in Ⅲgroup were significantly higher than those in group Ⅰand group Ⅱ(p<0.05).Conclusion Fundus Laser Combined with Anisodine and Triamcinolone acetonide can improve the curative effect of ischemic retinal vein occlusion, reduce the degree of macular edema and improve the hemodynamics of central venous occlusion.So as to can improve or preserve vision better.%目的 观察眼底激光、曲安奈德、复方樟柳碱联合治疗缺血型视网膜静脉阻塞患者的临床疗效.方法 前瞻性病例研究.研究对象为同仁医院2014年1月至2015年10月收治的缺血型视网膜静脉阻塞患者90例(90眼).方法按随机数字表分为Ⅰ组、Ⅱ组、Ⅲ组,每组各30例(30眼),三组患者均予以视网膜激光光凝(PRP)治疗,1周1次,共治疗4次,Ⅰ组再予以曲安奈德注射液患侧眼球周旁注射,每次注射1 ml(40 mg),每隔2周注射1次,共注射2次,Ⅱ组再予以复方樟柳碱注射液患侧眼颞浅动脉旁皮下注射,每次2 ml,1天1次,连续给药30 d,Ⅲ组再予以曲安奈德与复方樟柳碱注射液联合治疗.治疗前和治疗一个月后采用EDTRS视力表测定最佳矫正视力(BCVA),采用光学相干断层扫描(OCT)检查黄斑中心厚度(CMT),采用彩色多普勒超声检测视网膜中央动脉(CRA)和视网膜中央静脉(CRV)的血流动力学指标改善情况,评价视力疗效. 结果 Ⅲ组视力有效率明显高于Ⅰ组、Ⅱ组(p<0.05).Ⅲ组治疗后BCVA明显高于Ⅰ组、Ⅱ组(p<0.05),CMT明显低于Ⅰ组、Ⅱ组(p<0.05).Ⅲ组治疗后 CRA的收缩期峰值血流速度(PSV)和舒张末期血流速度(EDV)均明显高于Ⅰ组、Ⅱ组(p<0.05),阻力指数(RI)明显低于Ⅰ组、Ⅱ组(p<0.05);CRV的最大流速(Vmax)和最小流速(Vmin)均明显高于Ⅰ组、Ⅱ组(p<0.05).结论 眼底激光、曲安奈德、复方樟柳碱联合治疗能优化缺血型视网膜静脉阻塞的治疗效果,能有效减轻黄斑水肿的程度,改善中央静脉阻塞的血流动力学,从而更好改善或保存视力.
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