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要約 目的:黄斑疾患に対する20mgと40mgトリアムシノロンアセトニドのテノン囊下注射の効果の比較。対象と方法:黄斑疾患38例44眼を対象とした。糖尿病網膜症34眼,網膜静脈分枝閉塞症8眼,ぶどう膜炎2眼で,全例に囊胞様黄斑浮腫があった。症例を無差別に2群に分け,21眼には20mg,23眼には40mgトリアムシノロンアセトニドをテノン囊下に注射した。治療後3か月間の経過を追った。結果:投与の翌日から3か月後まで,各群で眼圧が上昇した。眼圧上昇は,投与の2か月後までは40mg群が20mg群よりも有意に高く,3か月後には両群間に有意差がなかった。中心窩網膜厚の減少と視力の改善については,両群間に差がなかった。結論:黄斑浮腫に対するトリアムシノロンアセトニドのテノン囊下注射では,20mg投与群と40mg投与群と効果が同様であり,40mg投与群では眼圧上昇効果が大きいことから,20mg投与が望ましい。
Abstract. Purpose:To report the effect and complication of subtenon injection of 20 mg and 40 mg triamcinolone acetonide for macular edema. Cases and Method:This study was made on 44 eyes of 38 cases of macular lesion. The series comprised diabetic retinopathy 34 eyes, branch retinal vein occlusion 8 eyes, and uveitis 2 eyes. All the eyes had cystoid macular edema(CME). Twenty-one eyes received 20 mg and 23 eyes received 40 mg triamcinolone as subtenon injection. Cases were followed up for 3 months. Results:Both groups showed elevated intraocular pressure(IOP)from the next day to 3 months after treatment. Increase in IOP was significantly greater in 40 mg than 20 mg group up to 2 months of treatment. There was no difference between the two groups regarding improvement of visual acuity and decrease of foveal thickness. Conclusion:There was no difference between 20 mg and 40 mg group in the beneficial effect for cystoid macular edema. Use of 20mg triamcinolone is advocated because of lesser IOP-raising effect.
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