Venkatesh Pradeep, Abhas Zaheer, Garg Satpal, Vohra Rajpal
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Graefes Arch Clin Exp Ophthalmol. 2007 Jan;245(1):59-67. doi: 10.1007/s00417-006-0378-3. Epub 2006 Aug 2.
To prospectively evaluate the efficacy of oral corticosteroids and posterior subtenon injection in the treatment of macular edema in patients with intermediate uveitis using optical coherence tomography (OCT).
Twenty-two patients with intermediate uveitis were treated with posterior subtenon injection when the disease was unilateral (group A, n=11) or with oral steroids when the disease was bilateral (group B, n=11). Changes in macular thickness from baseline was determined using OCT in both groups at day 0, day 3, day 14, 6 weeks and 12 weeks.
Statistically significant improvement in Snellen visual acuity in group A was seen at 6 weeks and in group B at 2 weeks. In patients receiving oral corticosteroids, foveal thickness decreased by 63% by day 3. In those treated with posterior subtenon injection, even at day 14 only a 55% reduction of foveal thickness was evident. Spearman's correlation coefficient for visual acuity and foveal thickness was found to be significant.
OCT confirms a significantly more rapid decrease in macular edema in patients treated with oral corticosteroids. A short course of oral steroids may be useful in enabling earlier visual recovery in patients treated with posterior subtenon injection for unilateral uveitic macular edema.
采用光学相干断层扫描（OCT）前瞻性评估口服皮质类固醇和后Tenon囊下注射治疗中间葡萄膜炎患者黄斑水肿的疗效。
22例中间葡萄膜炎患者，疾病单侧时采用后Tenon囊下注射治疗（A组，n = 11），疾病双侧时采用口服类固醇治疗（B组，n = 11）。两组均在第0天、第3天、第14天、6周和12周时使用OCT测定黄斑厚度相对于基线的变化。
A组在6周时、B组在2周时Snellen视力有统计学意义的显著改善。接受口服皮质类固醇治疗的患者，到第3天时黄斑中心凹厚度下降了63%。接受后Tenon囊下注射治疗的患者，即使在第14天时黄斑中心凹厚度也仅明显下降了55%。发现视力与黄斑中心凹厚度的Spearman相关系数具有显著性。
OCT证实口服皮质类固醇治疗的患者黄斑水肿下降明显更快。短期口服类固醇可能有助于接受后Tenon囊下注射治疗单侧葡萄膜炎性黄斑水肿的患者更早恢复视力。
