Ozdemir Hakan, Karacorlu Murat, Karacorlu Serra
Istanbul Retina Institute Inc., Istanbul, Turkey.
Acta Ophthalmol Scand. 2005 Apr;83(2):248-51. doi: 10.1111/j.1600-0420.2005.00395.x.
To evaluate the anatomic and visual outcomes of intravitreal triamcinolone acetonide injection in patients with cystoid macular oedema (CMO) secondary to retinitis pigmentosa (RP).
Five eyes of five patients with CMO secondary to RP, aged 25-41 years (mean 33.2 years) made up the study population. All eyes had persistent CMO despite medical treatment with 250 mg of oral acetazolamide twice daily for 1 month. Intravitreal injection of 4 mg (0.1 ml) triamcinolone acetonide was offered to treat macular oedema. The visual and anatomic responses were observed, as well as complications related to the injection procedure and corticosteroid medication.
Follow-up periods varied between 6 and 8 months (mean 6.8 months); all patients completed 6 months of follow-up. After intravitreal triamcinolone acetonide injection all patients showed good anatomic response. The baseline median central macular thickness was 418 microm (range 376-626 microm). At 1 month, the median central macular thickness had decreased to 224 microm (range 214-326 microm). At 3 and 6 months, the median central macular thicknesses were 275 microm (range 215-584 microm) and 312 microm (range 239-521 microm), respectively. Recurrent CMO was found in one patient at the 3-month follow-up and in two patients at the 6-month follow-up. Retreatment was performed in these patients. At the 1-month follow-up, no patient was found to have lost vision and two patients showed improvement. At the 3- and 6-month follow-ups, no patient had lost vision from baseline but no patient had maintained their improved visual acuity (VA).
In our small series, all patients showed an anatomic improvement in CMO after intravitreal injection of triamcinolone acetonide. However, in three out of five patients, despite good anatomic results, no improvement in VA was achieved. Because of the limitations of this pilot study, it is difficult to explain why no improvement in VA was achieved despite good anatomic results in some patients. Further study with longer follow-up periods and larger series is warranted to assess the efficacy of the treatment.
评估玻璃体内注射曲安奈德对继发于色素性视网膜炎（RP）的黄斑囊样水肿（CMO）患者的解剖学和视觉效果。
研究对象为5例继发于RP的CMO患者的5只眼，年龄25 - 41岁（平均33.2岁）。尽管每天口服250 mg乙酰唑胺，持续治疗1个月，但所有患眼的CMO仍持续存在。给予玻璃体内注射4 mg（0.1 ml）曲安奈德以治疗黄斑水肿。观察视觉和解剖学反应，以及与注射操作和皮质类固醇药物相关的并发症。
随访期为6至8个月（平均6.8个月）；所有患者均完成了6个月的随访。玻璃体内注射曲安奈德后，所有患者均显示出良好的解剖学反应。基线时黄斑中心厚度中位数为418微米（范围376 - 626微米）。1个月时，黄斑中心厚度中位数降至224微米（范围214 - 326微米）。3个月和6个月时，黄斑中心厚度中位数分别为275微米（范围215 - 584微米）和312微米（范围239 - 521微米）。在3个月随访时，1例患者出现CMO复发，6个月随访时，2例患者出现复发。对这些患者进行了再次治疗。在1个月随访时，未发现患者视力下降，2例患者视力改善。在3个月和6个月随访时，没有患者的视力相对于基线下降，但也没有患者维持改善后的视力（VA）。
在我们的小样本研究中，所有患者在玻璃体内注射曲安奈德后CMO均有解剖学改善。然而，五分之三的患者尽管解剖学结果良好，但视力并未改善。由于这项初步研究的局限性，难以解释为什么部分患者尽管解剖学结果良好但视力却未改善。有必要进行更长随访期和更大样本量的进一步研究，以评估该治疗方法的疗效。
