玻璃体内注射曲安奈德治疗非缺血性中央静脉阻塞的黄斑囊样水肿  

Intravitreal triamcinolone acetonide for cystoid macular edema in nonischemic central retinal vein occlusion

作　　者：Williamson T.H. O'Donnell A. 桑延智 

机构地区：[1]Department ofOphthalmology,St. Thomas'Hospital, Lambeth Palace Road, London SE1 7EH, United Kingdom Dr.

出　　处：《世界核心医学期刊文摘（眼科学分册）》2005年第9期17-18,共2页Digest of the World Core Medical Journals:Ophthalmology

摘　　要：PURPOSE: The effectiveness of intravitreal triamcinolone acetonide in the treatment of cystoid macular edema from central retinal vein occlusion (CRVO) was investigated. DESIGN: A noncomparative, prospective, interventional case series. METHODS: In a clinical practice, 18 patients were enrolled with nonischemic CRVO and cystoid macular edema. Two milligrams of triamcinolone acetonide were injected into the vitreous of only one eye from each patient. The outcome measures were 1-mm mean central retinal thickness on optical coherence tomography and visual acuity. RESULTS: Mean duration of symptoms before surgery was 2 months (SD, 1.3 months). Ten patients required repeated injections for recurrent cystoidmacular edema (mean,1.8 injections). Mean visual acuity significantly improved from 20/300 to 20/166 (P=.007) at 1 month, 20/100 (P=.0005) at 2 months, 20/130 (P=.007) at 3 months, and 20/150 (P=.02) at 6 months but deteriorated again to 20/270 (not significant) at 12 months. There was a significant improvement in retinal thickness from presentation 518 μm, to 363 μm (P=.03) at 1 month, 304 μm (P=.04) at 2 months, and 353 μm (P=.01) at 3 months but not from presentation at 6 months (mean, 383 μm) and 12 months (mean, 406 μm). Eleven patients suffered intraocular pressure rises requiring intervention. Intravitreal triamcinolone acetonide did not prevent collateral circulation formation, which was seen in 10 patients. CONCLUSION: Intravitreal corticosteroid injection is very effective in reversing cystoid macular edema and improving visual acuity in recent-onset nonischemic CRVO in the first 6 months, but this is unfortunately not sustained at 1 year.PURPOSE: The effectiveness of intravitreal triamcinolone acetonide in the treatment of cystoid macular edema from central retinal vein occlusion (CRVO) was investigated. DESIGN: A noncomparative, prospective, interventional case series. METHODS: In a clinical practice, 18 patients were enrolled with nonischemic CRVO and cystoid macular edema. Two milligrams of triamcinolone acetonide were injected into the vitreous of only one eye from each patient. The outcome measures were 1-mm mean central retinal thickness on optical coherence tomography and visual acuity. RESULTS: Mean duration of symptoms before surgery was 2 months (SD, 1.3 months). Ten patients required repeated injections for recurrent cystoidmacular edema (mean,1.8 injections). Mean visual acuity significantly improved from 20/300 to 20/166 (P=.007) at 1 month, 20/100 (P=.0005) at 2 months, 20/130 (P=.007) at 3 months, and 20/150 (P=.02) at 6 months but deteriorated again to 20/270 (not significant) at 12 months. There was a significant improvement in retinal thickness from presentation 518 μm, to 363 μm (P=.03) at 1 month, 304 μm (P=.04) at 2 months, and 353 μm (P=.01) at 3 months but not from presentation at 6 months (mean, 383 μm) and 12 months (mean, 406 μm). Eleven patients suffered intraocular pressure rises requiring intervention. Intravitreal triamcinolone acetonide did not prevent collateral circulation formation, which was seen in 10 patients. CONCLUSION: Intravitreal corticosteroid injection is very effective in reversing cystoid macular edema and improving visual acuity in recent-onset nonischemic CRVO in the first 6 months, but this is unfortunately not sustained at 1 year.

关 键 词：黄斑囊样水肿 中央静脉阻塞 玻璃体内注射 平均视力 玻璃体腔注射 干预性 侧支循环 眼内压 平均持续时间 

分 类 号：R774.5[医药卫生—眼科]