Tehrani N N, Saeed T, Murray P I
Birmingham and Midland Eye Centre, Birmingham, UK.
Eye (Lond). 2000 Oct;14 Pt 5:691-4. doi: 10.1038/eye.2000.185.
To study the use of intramuscular methylprednisolone in the treatment of cystoid macular oedema in patients with uveitis.
A total of 32 patients with various types of uveitis with unilateral cystoid macular oedema were recruited. Patients received 160 mg of intramuscular methylprednisolone into the thigh and were reassessed 6-8 weeks later. In 17 patients in whom there had been no significant improvement, a further injection of methylprednisolone was given; a total of 49 injections.
After a first injection a significant improvement in vision (an increase of > or = 2 Snellen lines) was seen in 15 of 32 eyes (47%), and 17 of 32 eyes (53%) showed no significant change. After the second injection 7 of 17 eyes (41%) showed a significant improvement but there was no change in 9 of 17 eyes (53%). Only one eye deteriorated more than 2 lines of Snellen acuity. There were minimal ocular or systemic side effects associated with this form of treatment.
Despite limited success, deep intramuscular methylprednisolone may have a role as an alternative mode of treatment in uveitis patients with unilateral cystoid macular oedema, thus avoiding the potential hazards of periocular injections. In comparison with orally administered systemic corticosteroids, an injection ensures patient compliance and is associated with fewer side effects.
研究肌肉注射甲泼尼龙治疗葡萄膜炎患者黄斑囊样水肿的疗效。
共招募了32例患有各种类型葡萄膜炎且单侧黄斑囊样水肿的患者。患者于大腿处肌肉注射160mg甲泼尼龙，并在6-8周后重新评估。17例视力无明显改善的患者再次注射甲泼尼龙，共注射49次。
首次注射后，32只眼中有15只（47%）视力显著提高（Snellen视力表提高≥2行），32只眼中有17只（53%）无明显变化。第二次注射后，17只眼中有7只（41%）视力显著提高，但17只眼中有9只（53%）无变化。仅1只眼的Snellen视力下降超过2行。这种治疗方式的眼部和全身副作用极小。
尽管疗效有限，但深部肌肉注射甲泼尼龙可作为治疗单侧黄斑囊样水肿葡萄膜炎患者的一种替代治疗方式，从而避免眼周注射的潜在风险。与口服全身用糖皮质激素相比，注射给药可确保患者的依从性，且副作用较少。
