目的：比较不同剂量曲安奈德(triamcinolone acetonide，TA)玻璃体腔注射治疗视网膜静脉阻塞性黄斑水肿的临床疗效和相关并发症，探讨有效安全的注射剂量。

方法：回顾性研究我院2015-01/2017-05收治的视网膜静脉阻塞性黄斑水肿患者62例62眼，根据注射剂量不同，分为1mg组、2mg组和4mg组，其中1mg组18例，2mg组22例，4mg组22例。分别予玻璃体腔注射曲安奈德1mg/0.025mL，2mg/0.05mL，4mg/0.1mL。于注射后1、3、6mo三个时间点进行随访，检查并比较三组患眼的最佳矫正视力(best corrected visual acuity，BCVA)、黄斑中心区视网膜厚度(central macular thickness，CMT)、眼压及并发症发生情况。

结果：三组患者注射前年龄、性别、病程、BCVA、CMT、眼压等方面比较，差异均无统计学意义(P>0.05)。1mg IVTA组在注射后1、3mo时，BCVA和CMT较治疗前均有改善(P<0.05)。2mg IVTA组、4mg IVTA组BCVA和CMT在注射后1、3、6mo时均优于治疗前(P<0.05)。注射后3mo和6mo时，2mg IVTA组和4mg IVTA组间BCVA和CMT比较，差异无统计学意义(P>0.05)，都优于1mg IVTA组(P<0.05)。 2mg IVTA组和4mg IVTA组分别有2例、6例患者发生眼压升高(≥22mmHg)，给予β-受体阻滞剂降眼压处理后，6mo随访期末除4mg IVTA组仍有1例需药物降压治疗外，其余均恢复正常(≤21mmHg)。

结论：2mg曲安奈德可能是玻璃体腔内注射治疗视网膜静脉阻塞性黄斑水肿比较合适的剂量。

METHODS: Totally 62 patients(62 eyes)with venous obstructive macular edema were divided into 1mg intravitreal injection of TA(IVTA)group, 2mg IVTA group and 4mg IVTA group, including 18 cases in group 1mg, 22 cases in 2mg group, and 22 cases in 4mg group according to the dosage of intravitreous. The intravitreal injection of TA as the dosage of 1mg/0.025mL, 2mg /0.05mL, 4mg/0.1mL were taken. At 1, 3 and 6mo after the injection, the items including best corrected visual acuity(BCVA), central macular thickness center(CMT), intraocular pressure and complications were examined and compared between the three groups.

RESULTS: There was no significant difference in age, sex, course of disease, BCVA, CMT and intraocular pressure in the three groups before injection(P>0.05). In 1mg IVTA group, BCVA and CMT were improved 1 and 3mo after treatment, compared with those before treatment(P<0.05). In 2mg IVTA group and 4mg IVTA group, BCVA and CMT were superior to those before treatment at 1, 3 and 6mo after injection(P<0.05). At 3 and 6mo after injected, there was no difference in BCVA and CMT between 2mg IVTA group and 4mg IVTA group(P>0.05), which was better than that of 1mg IVTA group(P<0.05). There were 2 cases, 6 cases in 2mg IVTA group and 4mg IVTA group had elevated intraocular pressure respectively(≥22mmHg)and beta receptor blockers were used to reduce the intraocular pressure. Except 1 cases in need of antihypertensive drug, the intraocular pressure of the rest patients were normal(less than 21mmHg)in 6mo follow-up period.

CONCLUSION: The 2mg triamcinolone acetonide may be a suitable dose of intravitreous intravitreal injection for the treatment of macular edema secondary to retinal vein occlusion.