目的: 观察玻璃体腔内注射曲安奈德( TA) 治疗糖尿病性黄斑水肿( DME) 后眼压( IOP) 升高及控制
情况。方法: 本研究为前瞻性、介入性、剂量－疗效研究。62 例83 眼DME 病人，随机分为两组，一组病人行玻璃
体腔内注射曲安奈德4mg( A 组，42 眼) ，另一组玻璃体腔注射曲安奈德8mg( B 组，41 眼) 。注射术后随访6mo;
并于1mo，3mo，6mo 进行眼压测量及控制。结果: 曲安奈德玻璃体腔注射后，两组病人术后眼压升高发生率分别
为76．2%、73．2%。降眼压药物用于控制眼压大部分病人可达到满意效果，6 例术后青光眼需滤过手术治疗。结
论: 尽管玻璃体腔内注射曲安奈德是非常有效的DME 治疗手段，但高眼压和致青光眼是其主要并发症。但我们
推测高皮质醇应答是一种个性化反应，与曲安奈德玻璃体腔注射剂量无关。

Objective: To evaluate the changes in intraocular pressure( IOP) after intravitreal injection
of triamcinolone acetonide for the management of diabetic macular edema( DME) ．Methods: The
study design is a prospective， interventional，dose－response study．83 eyes with DME were included，
Randomly divided into two groups，eyes of one group underwent intravitreal injection of 4 mg triamcinolone
acetonide( 42 eyes) ，and eyes of another group underwent intravitreal injection of 8 mg triamcinolone
acetonide ( 41eyes) ; The patients were followed up for 6months after injection; Intraocular
pressure was measuremented and controled．Results: After injection．Significant IOP rise was observed in
both groups with an incidence of 76．2%and 73．2%in groups A and B， respectively．IOP－lowering drugs
were used to control IOP， satisfactory effect was achieved．however， six eyes needed glaucoma filtration
surgery after intractable glaucoma with failure of medical treatme－nt．Conclusion: Although intravitreal
injection of triamcinolone acetonide is very effective in managing DME and with lower cost than other
modalities，the rise in IOP and the burden of glaucoma are major concerns． High corticosteroid
responder is an individualized reaction irrespective of the intravitreal triamcinolone acetonide dose
used．

R775．9

 收稿日期: 2016－07－15; 修回日期: 2016－09－19
基金项目: 内蒙古自然科学基金项目( 2016MS0872)
作者简介: 李兰根( 1973－) ，男，内蒙古自治区人民医院眼科副主任医师。