Jonas J B, Kreissig I, Degenring R F
Universitäts-Augenklinik, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.
Br J Ophthalmol. 2004 Dec;88(12):1557-62. doi: 10.1136/bjo.2003.039552.
To evaluate factors influencing change in visual acuity (VA) after intravitreal injection of triamcinolone acetonide as treatment of exudative age related macular degeneration (AMD).
This prospective, interventional, comparative non-randomised clinical case series study included 94 patients (99 eyes) showing progressive exudative AMD with occult (n = 61 eyes), minimally classic (n = 18), predominantly classic (n = 1), or totally classic (n = 8) subfoveal neovascularisation. Mean follow up was 8.5 (SD 4.7) months (median, 7.3 months; range 3.1-24.5 months). All patients received an intravitreal injection of 20-25 mg of triamcinolone acetonide.
An increase in best VA of at least one line on the Snellen charts was found in 63 (63.1%) eyes. Correspondingly, mean VA increased significantly (p<0.001) from 0.17 (SD 0.13) to 0.22 (SD 0.17) after the injection. Postoperative increase in VA was significantly (p<0.001) and negatively correlated with preoperative VA (correlation coefficient, -0.49). Gain in visual acuity was significantly (p = 0.009) higher if preoperative visual acuity was less than 0.08 (gain: 3.2 (SD 2.9) Snellen lines) than if preoperative VA ranged between 0.08 and 0.20 (gain: 1.2 (SD 2.2) Snellen lines). Change in VA was significantly (p = 0.016) less if preoperative VA was higher than 0.20 (change: -0.8 (SD 3.4) Snellen lines). Maximal gain in VA was significantly (p = 0.035) larger in eyes with retinal pigment epithelium detachment than in eyes with minimally classic subfoveal neovascularisation. This was statistically independent of age (p = 0.99), refractive error (p = 0.88), sex (p = 0.92), and duration of follow up (p = 0.46).
Gain in VA after intravitreal injection of 20-25 mg of triamcinolone acetonide is significantly and negatively correlated with preoperative VA. It is significantly larger in eyes with retinal pigment epithelium detachment than in eyes with minimally classic subfoveal neovascularisation.
评估玻璃体内注射曲安奈德治疗渗出性年龄相关性黄斑变性（AMD）后影响视力（VA）变化的因素。
这项前瞻性、干预性、非随机对照临床病例系列研究纳入了94例患者（99只眼），这些患者均表现为隐匿性（n = 61只眼）、微小经典型（n = 18只眼）、主要经典型（n = 1只眼）或完全经典型（n = 8只眼）黄斑中心凹下新生血管形成的进行性渗出性AMD。平均随访时间为8.5（标准差4.7）个月（中位数7.3个月；范围3.1 - 24.5个月）。所有患者均接受了20 - 25 mg曲安奈德的玻璃体内注射。
63只眼（63.1%）的最佳矫正视力在Snellen视力表上至少提高了一行。相应地，注射后平均视力从0.17（标准差0.13）显著提高到0.22（标准差0.17）（p<0.001）。术后视力提高与术前视力显著负相关（p<0.001，相关系数 - 0.49）。术前视力低于0.08时视力提高显著更高（提高：3.2（标准差2.9）Snellen行），而术前视力在0.08至0.20之间时提高为1.2（标准差2.2）Snellen行（p = 0.009）。术前视力高于0.20时视力变化显著更小（变化： - 0.8（标准差3.4）Snellen行）（p = 0.016）。视网膜色素上皮脱离的眼中视力最大提高显著大于微小经典型黄斑中心凹下新生血管形成的眼（p = 0.035）。这在统计学上与年龄（p = 0.99）、屈光不正（p = 0.88）、性别（p = 0.92）及随访时间（p = 0.46）无关。
玻璃体内注射20 - 25 mg曲安奈德后视力提高与术前视力显著负相关。视网膜色素上皮脱离的眼中视力提高显著大于微小经典型黄斑中心凹下新生血管形成的眼。
