Application Of IVTA Treatment Of Macular Edema At The Primary Hospital

Objective: to domestic intravitreal injection of triamcinolone acetonide in the treatment of various diseases caused by macular edema and macular area the safety and efficacy of new blood vessels, find a suitable treatment method of macular edema and the new blood vessels of macular for basic-level hospital, reduce blindness and low vision. Finish this treatment method of clinical observation and study of the large sample. Methods the test group: inject triamcinolone acetonide to the intravitreal of the patients. Surgical methods: after surface anesthesia of the operation eye, the 1% iodine disinfect the area of treatment eye. Open the eyelids with the eye speculum, draw off 0.1ml triamc- inolone acetonide from the 40mg/ml of domestic triamcinolone acetonide suspension fluid with No. TB with needles, by sclerotic of inside the eyelid corner sclerotic 4mm Department slow fate inject into the vitreous cavity. thecontrol group: conventionally adopt argon laser photocoagulation retina and improve microcirculation drug therapy. Regular review and follow up the change situation of the vision, intraocular pressure, intraocular pressure and the opacity level of the len Results all of the patients completed the review examination of 1 week after the operation, 140 patients completed the review examination of 1 month after the operation, 120 patients with 3 months follow-up, 80 patients completed 6 months follow-up. Results showed that all patients were not present inflammation of anterior segment. Six patients appear maturity peried cataract. The vision in test group after 1 week,1,3 months compared with the preoperative visual acuity was improved respectively (p<001; p<0.001; p=0.024; a=0.05). No eyesight continue to fall. (table 1) Use OCT to measure the thickness macular center. Macular edema after 1 and 3 months was decreased significantly compared with those before treamaent in test group (p<0. 001, a=0.05). (table 2) but Macular edema after 3 months was not decreased significantly compared with those before treamaent (p=0.06, a=0.05), maybe it was associated with the quantity of the follow-up to 3 months of the patients. Fundus fluorescein angiography (FFA) showed a significant decrease in macular leakage, even no leakage in some patients. Color fundus photography showed that the size of hard exudates and the volume decreased significantly.There are 13.5%-1.29% patients whose eye pressure elevates>21mmHg. They come out at 1 week, 1 and 3 months after operation. 1 month is the high intraocular pressure occurred when the rush hour, and then gradually decreases. Most high intraocular pressure can be controlled at 6 months. 2 cases of intractable elevation intraocular pressure accept the conventional filtration surgery, the intraocular pressure can be controlled at 15-18 mmHg.Conclusion:1. the visuaI acuity of TA treatment was improved or unchanged. Most of the control group was improved,but the visuaI acuity of some people (15%) continue to fall.2. In the group TA macular edema decreased or disappeared. Mean central macular thickness in Group TA was lower than that in the control group. There is significant difference (P<0.001).3. The experimental group, vitreous after intravitreal triamcinolone acetonide intraocular inflammatory response (vitreous opacities exudative retinal detachment) to reduce. The control group conventional treatment was not obvious improvement.4. The transient intraocular pressure elevated in Group TA. In the control group in the least undergoing IOP.5. Experimental group intravitreal injection of triamcinolone acetonide did not happen infectious endophthalmitis, vitreous hemorrhage, retinal tears and detachment-related complications. Conventional treatment group and no complications in this group.6. Experimental clinical study group and control groups to compare the incidence of cataract was no significant difference.7. Basic research also shows that the vitreous cavity of TA injection group the incidence of cataract is not high than other control group.Intravitreal injection of domestic triamcinolone acetonide has a good security. The method is economic, simple, practical, effective and safe. There is an effective way to treatment macular edema and neovascular macular disease in basic-level hospital.