Ranson N T, Danis R P, Ciulla T A, Pratt L
Department of Ophthalmology, Indiana University School of Medicine, 702 Rotary Circle, Indianapolis, IN 46202, USA.
Br J Ophthalmol. 2002 May;86(5):527-9. doi: 10.1136/bjo.86.5.527.
Laser treatment of extrafoveal well delineated choroidal neovascularisation in exudative age related macular degeneration has a high rate of failure with subsequent severe vision loss from subfoveal involvement. Laser treatment may limit scotoma size, but is unpalatable because of early persistent vision loss. Intravitreal triamacinolone injection may be an acceptable alternative therapy in such disparate cases.
14 consecutive patients with recurrent neovascularisation were treated with a single 4.0 mg injection of triamacinolone and followed for up to 1 year. Visual results were compared with published data from the Macular Photocoagulation Study of recurrent neovascularisation.
Mean visual acuity remained stable at about 20/200 throughout the study period in the treated patients. This is comparable to the outcomes in the Macular Photocoagulation Study for laser retreated patients, and better than the observation group.
Intravitreal triamcinolone may be an acceptable treatment of subfoveal recurrent neovascularisation while avoiding early persistent vision loss from laser retreatment.
对于渗出性年龄相关性黄斑变性中黄斑中心凹外边界清晰的脉络膜新生血管，激光治疗失败率高，随后因黄斑中心凹受累导致严重视力丧失。激光治疗可能会限制暗点大小，但由于早期持续视力丧失而难以接受。在这类不同的病例中，玻璃体内注射曲安奈德可能是一种可接受的替代疗法。
14例复发性新生血管患者接受单次4.0毫克曲安奈德注射治疗，并随访长达1年。将视觉结果与黄斑光凝研究中复发性新生血管的已发表数据进行比较。
在整个研究期间，治疗患者的平均视力保持稳定在约20/200。这与黄斑光凝研究中接受激光再治疗患者的结果相当，且优于观察组。
玻璃体内注射曲安奈德可能是治疗黄斑中心凹下复发性新生血管的一种可接受的方法，同时避免了激光再治疗导致的早期持续视力丧失。
