Young S, Larkin G, Branley M, Lightman S
Department of Clinical Ophthalmology, Institute of Ophthalmology, Moorfields Eye Hospital, London, UK.
Clin Exp Ophthalmol. 2001 Feb;29(1):2-6. doi: 10.1046/j.1442-9071.2001.00360.x.
To report the safety and efficacy of intravitreal triamcinolone in the treatment of inflammatory cystoid macular oedema (CMO) in six patients who were resistant to other forms of therapy.
An open-label unmasked prospective nonrandomized pilot study of six patients with idiopathic uveitis and visually significant macular oedema, resistant to periocular and/or systemic corticosteroid treatment, was carried out. Baseline examination and investigations were performed, including fundus fluorescein angiography, and the patients were given a single intravitreal injection of triamcinolone (4 mg/0.1 mL). The primary outcome measure was angiographic resolution of CMO. Patients were reviewed at intervals of 2-4 weeks for 12 months.
A single intravitreal injection of triamcinolone induced clinical and angiographic resolution of inflammatory macular oedema in all patients for varying periods of time up to 6 months. Five patients experienced increased intraocular pressure to 30 mmHg or greater which required treatment. Two patients developed posterior subcapsular cataract.
One injection of intravitreal triamcinolone was an effective short-term treatment for resistant CMO in uveitis. As with steroids given by other routes, raised intraocular pressure and cataract may occur. As it was so effective in these eyes with resistant CMO, a larger study is warranted to evaluate this form of therapy.
报告玻璃体内注射曲安奈德治疗6例对其他治疗方式耐药的炎症性黄斑囊样水肿（CMO）患者的安全性和有效性。
对6例患有特发性葡萄膜炎且黄斑水肿明显、对眼周和/或全身皮质类固醇治疗耐药的患者进行了一项开放标签、非盲法前瞻性非随机试验研究。进行了包括眼底荧光血管造影在内的基线检查和调查，患者接受了一次玻璃体内注射曲安奈德（4mg/0.1mL）。主要观察指标是CMO的血管造影消退情况。对患者进行了为期12个月、间隔2至4周的复查。
单次玻璃体内注射曲安奈德在长达6个月的不同时间段内使所有患者的炎症性黄斑水肿在临床和血管造影上得到消退。5例患者眼压升高至30mmHg或更高，需要进行治疗。2例患者出现后囊下白内障。
单次玻璃体内注射曲安奈德是治疗葡萄膜炎中耐药CMO的一种有效的短期治疗方法。与通过其他途径给予的类固醇一样，可能会出现眼压升高和白内障。由于其对这些耐药CMO眼非常有效，因此有必要进行更大规模的研究来评估这种治疗方式。
