玻璃体内注射曲安奈德治疗结节病性脉络膜肉芽肿
Intravitreal triamcinolone acetonide for choroidal granuloma in sarcoidosis.
作者信息
Chan Wai-Man, Lim Etrian, Liu David T L, Law Ricky W K, Lam Dennis S C
机构信息
Department of Ophthalmology and Visual Sciences, the Chinese University of Hong Kong, 3/F Hong Kong Eye Hospital, 147K Argyle Street, Kowloon, Hong Kong, People's Republic of China.
出版信息
Am J Ophthalmol. 2005 Jun;139(6):1116-8. doi: 10.1016/j.ajo.2004.11.055.
PURPOSE
To report the clinical course of intravitreal triamcinolone acetonide on choroidal granuloma secondary to sarcoidosis that was refractory to systemic prednisolone
DESIGN
Interventional case report.
METHODS
A 29-year-old Chinese man with sarcoidosis presented with isolated posterior segment involvement in his left eye as retinal periphlebitis, retinal granulomas, and choroidal granuloma. Retinal periphlebitis and retinal granulomas responded well to oral corticosteroid but not the choroidal granuloma. It gradually grew in size and caused a drop in left-eye vision to 20/70. Intravitreal triamcinolone acetonide (4 mg) was injected three times in total.
RESULTS
The choroidal mass began to shrink in size after the second injection and completely regressed after the third. The choroidal granuloma became a scar, with no angiographic leakage. The patient's visual acuity improved and remained stable at 20/40 at the last follow-up, 6 months after the last injection.
CONCLUSIONS
Given the encouraging results, further study on intravitreal triamcinolone acetonide for macular and peripapillary choroidal granulomas secondary to systemic sarcoidosis is warranted.
目的
报告玻璃体内注射曲安奈德治疗结节病继发脉络膜肉芽肿的临床过程，该脉络膜肉芽肿对全身应用泼尼松龙治疗无效。
设计
干预性病例报告。
方法
一名29岁的中国男性结节病患者，左眼仅后段受累，表现为视网膜静脉周围炎、视网膜肉芽肿和脉络膜肉芽肿。视网膜静脉周围炎和视网膜肉芽肿对口服糖皮质激素反应良好，但脉络膜肉芽肿无反应。其大小逐渐增大，导致左眼视力降至20/70。共进行了3次玻璃体内注射曲安奈德（4毫克）。
结果
第二次注射后脉络膜肿物开始缩小，第三次注射后完全消退。脉络膜肉芽肿形成瘢痕，血管造影无渗漏。患者视力改善，在最后一次注射后6个月的最后一次随访时稳定在20/40。
结论
鉴于取得了令人鼓舞的结果，有必要对玻璃体内注射曲安奈德治疗系统性结节病继发的黄斑和视乳头周围脉络膜肉芽肿进行进一步研究。
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