Kubota Toshiaki, Okabe Hakuoh, Hisatomi Toshio, Yamakiri Keita, Sakamoto Taiji, Tawara Akihiko
Department of Ophthalmology, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
J Glaucoma. 2006 Apr;15(2):117-9. doi: 10.1097/00061198-200604000-00007.
To study the histology of the trabecular meshwork of eyes with glaucoma by intravitreal injection of triamcinolone acetonide (TA).
Two cases report.
PARTICIPANTS/METHODS: A 68-year-old Japanese man with branch retinal vein occlusion and a 48-year-old Japanese woman with uveitis were treated by cataract surgery, intraocular lens implantation, and TA-assisted pars plana vitrectomy. At the end of surgery, TA suspension (4 mg) was intravitreously injected. During the follow-up period, the intraocular pressure (IOP) of the patients increased over 30 mm Hg even with full medication. Trabeculectomy was performed at 4 months after TA injection in case 1 and at 6 months in case 2, and intraocular pressure returned to the normal range in both cases. Light and electron microscopic studies of the resected trabecular tissue were carried out.
The histology showed minimal deposition of extracellular matrix in the trabecular meshwork in case 1. Case 2 showed the beginnings of deposition of extracellular matrix including fingerprintlike material in the trabecular meshwork with decreased intertrabecular spaces.
The ultrastructural changes in the trabecular meshwork of eyes with glaucoma after treatment with intravitreal TA might resemble those with glaucoma after topical corticosteroid treatment.
通过玻璃体内注射曲安奈德（TA）研究青光眼患者小梁网的组织学变化。
病例报告两篇。
研究对象/方法：一名68岁患有视网膜分支静脉阻塞的日本男性和一名48岁患有葡萄膜炎的日本女性接受了白内障手术、人工晶状体植入术以及TA辅助的扁平部玻璃体切除术。手术结束时，玻璃体内注射TA悬液（4毫克）。在随访期间，即使使用了全部药物治疗，患者的眼压（IOP）仍升高至30毫米汞柱以上。病例1在TA注射后4个月进行小梁切除术，病例2在6个月后进行，两例患者的眼压均恢复到正常范围。对切除的小梁组织进行了光镜和电镜研究。
病例1的组织学检查显示小梁网中细胞外基质沉积极少。病例2显示小梁网中开始出现包括指纹样物质在内的细胞外基质沉积，小梁间隙减小。
玻璃体内注射TA治疗后青光眼患者小梁网的超微结构变化可能与局部应用皮质类固醇治疗后的青光眼相似。
