Jonas Jost B, Spandau Ulrich H, Kamppeter Bernd A, Vossmerbaeumer Urs, Harder Bjoern
Department of Ophthalmology, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Mannheim, Germany.
Ophthalmic Res. 2006;38(6):324-8. doi: 10.1159/000096226. Epub 2006 Oct 13.
Intravitreal triamcinolone acetonide has been discussed as treatment for exudative age-related macular degeneration (AMD).
To give an updated report on repeated intravitreal injections of triamcinolone acetonide (IVTA) for the treatment of exudative AMD.
The case-series study included 24 patients (24 eyes) with progressive exudative AMD who had shown an increase in, or stabilization of, visual acuity after a first IVTA, and who eventually experienced a deterioration of visual acuity. The 24 (6.5%) eyes were selected out of a total group of 369 eyes who had received IVTA for exudative AMD within the last 5 years. All patients of the study received a second IVTA (approximately 20 mg) 3.7-38.5 months after the first injection. Main outcome measure was visual acuity.
After the first injection, best corrected visual acuity improved significantly (p = 0.001) from 0.75 +/- 0.34 logMAR to a minimum of 0.58 +/- 0.30 logMAR during follow-up, with 10 (42%) eyes improving in visual acuity by two or more Snellen lines. Towards the end of follow-up after the first injection, best corrected visual acuity decreased significantly (p = 0.03) compared with the baseline value. After the second injection, visual acuity did not change markedly from baseline to a mean maximal visual acuity during follow-up. Comparing the last postoperative examination at the end of the follow-up after the second IVTA with the preoperative examination, a significantly (p = 0.001) higher number of eyes lost in visual acuity [19 (79%) eyes] than gained in visual acuity [3 (12%) eyes].
In selected eyes with an increase in visual acuity after a first IVTA (20 mg), repeated IVTA temporarily stabilizes visual acuity with a drop in visual acuity towards the end of follow-up.
玻璃体内注射曲安奈德已被作为渗出性年龄相关性黄斑变性（AMD）的一种治疗方法进行讨论。
给出关于重复玻璃体内注射曲安奈德（IVTA）治疗渗出性AMD的最新报告。
该病例系列研究纳入了24例（24只眼）进展性渗出性AMD患者，这些患者在首次IVTA后视力有所提高或稳定，但最终视力出现了下降。这24只眼（6.5%）是从过去5年内接受IVTA治疗渗出性AMD的369只眼中挑选出来的。研究中的所有患者在首次注射后3.7 - 38.5个月接受了第二次IVTA（约20mg）。主要观察指标为视力。
首次注射后，最佳矫正视力在随访期间从0.75±0.34 logMAR显著提高（p = 0.001）至最低0.58±0.30 logMAR，其中10只眼（42%）的视力提高了两行或更多行Snellen视力表行数。在首次注射随访接近尾声时，与基线值相比，最佳矫正视力显著下降（p = 0.03）。第二次注射后，从基线到随访期间的平均最大视力，视力没有明显变化。将第二次IVTA随访结束时的最后一次术后检查与术前检查进行比较，视力下降的眼数[19只眼（79%）]显著多于视力提高的眼数[3只眼（12%）]（p = 0.001）。
在首次IVTA（20mg）后视力提高的特定眼中，重复IVTA可暂时稳定视力，但在随访末期视力会下降。
