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经巩膜Tenon囊下注射曲安奈德治疗近视性脉络膜新生血管

Trans-Tenon's retrobulbar triamcinolone infusion for myopic choroidal neovascularization.

作者信息

Kojima Ariko, Ohno-Matsui Kyoko, Futagami Soh, Shimada Noriaki, Tokoro Takashi, Mochizuki Manabu

机构信息

Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan.

出版信息

Acta Ophthalmol Scand. 2006 Dec;84(6):749-54. doi: 10.1111/j.1600-0420.2006.00745.x.

Abstract

PURPOSE

To report the effects of trans-Tenon's retrobulbar injection of triamcinolone acetonide for subfoveal and juxtafoveal choroidal neovascularization (CNV) caused by pathological myopia.

METHODS

Eleven consecutive patients (11 eyes) with myopic CNV were treated with trans-Tenon's retrobulbar injection of triamcinolone acetonide. Each patient received a single injection. Evaluation included best corrected visual acuity (BCVA) measurements, fluorescein fundus angiography, retinal oedema examined by optical coherence tomography (OCT), and retinal sensitivity using scanning laser ophthalmoscopy (SLO) at the initial examination and at 6 and 12 months after treatment.

RESULTS

At 6 months after treatment, BCVA had improved by at least two ETDRS lines in eight eyes, and remained unchanged in three eyes. No eye showed worsening of VA by two or more ETDRS lines. At 12 months, BCVA had improved by at least two ETDRS lines in 10 eyes and remained unchanged in only one eye. The size of the CNV decreased in all patients after treatment. Fluorescein fundus angiography revealed an absence of dye leakage in the late angiographic phase. Optical coherence tomography revealed decreased retinal oedema in all patients and SLO microperimetry revealed an increase in retinal sensitivity in seven eyes, at both 6 and 12 months after treatment. Chorioretinal atrophy developed around the CNV in 10 eyes at 6 months and in all eyes at 12 months after treatment.

CONCLUSIONS

Trans-Tenon's retrobulbar injection of triamcinolone acetonide for CNV resulting from pathological myopia appears to be relatively safe and to have a good visual outcome, although a longterm follow-up study in a larger series of patients is necessary.

摘要

目的

报告经巩膜Tenon囊下注射曲安奈德治疗病理性近视性黄斑中心凹下及近黄斑中心凹脉络膜新生血管(CNV)的效果。

方法

连续11例(11只眼)近视性CNV患者接受经巩膜Tenon囊下注射曲安奈德治疗。每位患者接受单次注射。评估包括初始检查时以及治疗后6个月和12个月时的最佳矫正视力(BCVA)测量、荧光素眼底血管造影、光学相干断层扫描(OCT)检查的视网膜水肿以及扫描激光检眼镜(SLO)检查的视网膜敏感度。

结果

治疗后6个月,8只眼的BCVA至少提高了两条ETDRS视力行,3只眼保持不变。没有眼的视力下降两条或更多ETDRS视力行。治疗后12个月,10只眼的BCVA至少提高了两条ETDRS视力行,仅1只眼保持不变。所有患者治疗后CNV大小均减小。荧光素眼底血管造影显示造影晚期无染料渗漏。光学相干断层扫描显示所有患者的视网膜水肿减轻,扫描激光检眼镜微视野检查显示治疗后6个月和12个月时7只眼的视网膜敏感度增加。治疗后6个月,10只眼的CNV周围出现脉络膜视网膜萎缩,12个月时所有眼均出现。

结论

经巩膜Tenon囊下注射曲安奈德治疗病理性近视性CNV似乎相对安全且视力预后良好,尽管需要对更多患者进行长期随访研究。

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