Ozkiris Abdullah
Department of Ophthalmology, Erciyes University Medical Faculty, Kayseri, Turkey.
Ocul Immunol Inflamm. 2006 Aug;14(4):233-8. doi: 10.1080/09273940600826604.
To assess the efficacy and complications of intravitreal triamcinolone acetonide (IVTA) injection in the treatment of posterior uveitis and to compare the outcomes with patients who had received systemic corticosteroids.
This prospective, interventional, clinical case series study included 11 eyes of 9 patients who received 8 mg/0.2 ml of IVTA injection for posterior uveitis that involved vitreous inflammation (group 1). Control group (group 2) consisted of 15 eyes of 12 patients who had received systemic corticosteroids for treatment of posterior uveitis with vitreous inflammation. The main outcome measures included best-corrected visual acuity, vitreous inflammation score and intraocular pressure.
In group 1, mean visual acuity improved significantly (P < 0.001) from a mean logarithm of the minimum angle of resolution (LogMAR) value of 2.05 +/- 0.82 at baseline to a maximum of 0.33 +/- 0.22 during the follow-up period of 5.0 +/- 2.8 months. In control group, mean LogMAR visual acuity before systemic corticosteroid therapy was 1.82 +/- 0.78, and it has reached a maximum of 0.40 +/- 0.22 after treatment (P < 0.001). The mean inflammatory scores decreased significantly in both groups when compared with preinjection values (for each, P < 0.05). There were no statistically significant differences between group 1 and group 2 when pre-and posttreatment visual acuities and inflammatory scores at 1-, 3-, and 5-month follow-up examinations were compared (for each, P > 0.05). In group 1, mean intraocular pressure (IOP) increased significantly from 13.4 +/- 2.6 mmHg to a mean maximal value of 19.3 +/- 4.3 mmHg (P < 0.001), but there was no statistically significant difference between mean IOP at 5-month after IVTA injection and pretreatment value (P = 0.06). Cataract progression was observed in one eye.
IVTA application may be an alternative therapeutic option for the treatment of acute posterior uveitis that involves vitreous inflammation, especially in patients who carry risks for systemic corticosteroid therapy.
评估玻璃体内注射曲安奈德（IVTA）治疗后葡萄膜炎的疗效及并发症，并与接受全身糖皮质激素治疗的患者的治疗结果进行比较。
这项前瞻性、干预性临床病例系列研究纳入了9例患者的11只眼，这些患者因累及玻璃体炎症的后葡萄膜炎接受了8mg/0.2ml的IVTA注射（第1组）。对照组（第2组）由12例患者的15只眼组成，这些患者因累及玻璃体炎症的后葡萄膜炎接受了全身糖皮质激素治疗。主要观察指标包括最佳矫正视力、玻璃体炎症评分和眼压。
在第1组中，平均视力从基线时最小分辨角对数（LogMAR）值2.05±0.82显著提高（P<0.001），在5.0±2.8个月的随访期内最高达到0.33±0.22。在对照组中，全身糖皮质激素治疗前的平均LogMAR视力为1.82±0.78，治疗后最高达到0.40±0.22（P<0.001）。与注射前值相比，两组的平均炎症评分均显著降低（每组P<0.05）。在1个月、3个月和5个月的随访检查中，比较治疗前后的视力和炎症评分时，第1组和第2组之间无统计学显著差异（每组P>0.05）。在第1组中，平均眼压（IOP）从13.4±2.6mmHg显著升高至平均最大值19.3±4.3mmHg（P<0.001），但IVTA注射后5个月的平均眼压与治疗前值之间无统计学显著差异（P=0.06）。观察到一只眼出现白内障进展。
IVTA应用可能是治疗累及玻璃体炎症的急性后葡萄膜炎的一种替代治疗选择，尤其是对于有全身糖皮质激素治疗风险的患者。
