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玻璃体内注射曲安奈德治疗白塞病性黄斑囊样水肿

Intravitreal triamcinolone acetonide in the management of cystoid macular edema in Behçet's disease.

作者信息

Atmaca Leyla Suna, Yalçindağ F Nilüfer, Ozdemir Ozden

机构信息

Department of Ophthalmology, Ankara University Medical School, Ankara, Turkey.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2007 Mar;245(3):451-6. doi: 10.1007/s00417-006-0514-0. Epub 2007 Jan 17.

Abstract

PURPOSE

To determine the efficacy of intravitreal triamcinolone acetonide (ivTA) injection in the management of cystoid macular edema (CME) due to uveitis in patients with Behçet's disease.

METHODS

Ten eyes of seven patients with CME associated with Behçet's disease were included in the study. A quantity of 4 mg of triamcinolone acetonide was injected intravitreally in all of the eyes. The maculas of the patients were evaluated with optical coherence tomography (OCT) and fluorescein angiography (FA). The change in visual acuity, fluorescein leakage, macular thickness, and potential complications were assessed.

RESULTS

The mean follow-up was 15.6 months (range 7-19 months). There was an increase of more than two Snellen lines in the visual acuity in seven of the ten eyes (70%) at the last examination. Macular edema regressed completely in eight of the ten eyes (80%) at the last visit on OCT and FA. The mean central macular thickness assessed by OCT was 406 mum before treatment and 186.9 mum at the last visit. The intraocular pressure (IOP) exceeded 21 mmHg in six eyes of five patients (60%) during the follow-up. At the last visit, the IOP was less than 21 mmHg in five eyes with medication. One eye underwent glaucoma filtration surgery. Four eyes of three patients had cataract progression. In four eyes of four patients (40%), a second ivTA injection was given due to relapsing CME.

CONCLUSION

Intravitreal triamcinolone acetonide (ivTA) may be beneficial in the management of CME in patients with Behçet's disease. Repeated ivTA injections might be required if CME reoccurs.

摘要

目的

确定玻璃体内注射曲安奈德(ivTA)治疗白塞病患者葡萄膜炎所致黄斑囊样水肿(CME)的疗效。

方法

本研究纳入7例患有与白塞病相关CME的患者的10只眼。所有眼均玻璃体内注射4mg曲安奈德。采用光学相干断层扫描(OCT)和荧光素血管造影(FA)对患者的黄斑进行评估。评估视力变化、荧光素渗漏、黄斑厚度及潜在并发症。

结果

平均随访15.6个月(范围7 - 19个月)。在最后一次检查时,10只眼中有7只眼(70%)的视力提高超过两行Snellen视力表。在最后一次OCT和FA检查时,10只眼中有8只眼(80%)的黄斑水肿完全消退。OCT评估的平均中心黄斑厚度在治疗前为406μm,最后一次检查时为186.9μm。随访期间,5例患者的6只眼(60%)眼压超过21mmHg。在最后一次检查时,5只用药眼的眼压低于21mmHg。1只眼接受了青光眼滤过手术。3例患者的4只眼出现白内障进展。4例患者的4只眼(40%)因CME复发接受了第二次ivTA注射。

结论

玻璃体内注射曲安奈德(ivTA)可能有助于治疗白塞病患者的CME。如果CME复发,可能需要重复注射ivTA。

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