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玻璃体内注射曲安奈德作为激光全视网膜光凝治疗合并增殖性糖尿病视网膜病变及临床上显著黄斑水肿的辅助治疗。

Intravitreal triamcinolone as adjunctive treatment to laser panretinal photocoagulation for concomitant proliferative diabetic retinopathy and clinically significant macular oedema.

作者信息

Margolis Ron, Singh Rishi P, Bhatnagar Pawan, Kaiser Peter K

机构信息

Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.

出版信息

Acta Ophthalmol. 2008 Feb;86(1):105-10. doi: 10.1111/j.1600-0420.2007.00940.x. Epub 2007 Jul 3.

Abstract

PURPOSE

To evaluate the effect of intravitreal injections of triamcinolone acetonide (IVTA) combined with panretinal photocoagulation (PRP) on visual acuity (VA) and foveal thickness in patients with concomitant high-risk proliferative diabetic retinopathy (PDR) and clinically significant macular oedema (CSMO).

METHODS

This retrospective interventional case series included seven eyes diagnosed with both high-risk PDR and CSMO that underwent PRP and a single injection of 4 mg of IVTA. The main outcome measures were VA and foveal thickness, measured by optical coherence tomography (OCT) before treatment and throughout the follow-up period.

RESULTS

Median follow-up was 301 days (range 180-715 days). Foveal thickness data were available for four of seven eyes. Before the combined treatment, median LogMAR (logarithm of the minimum angle of resolution) VA and median foveal thickness were 1 (Snellen 20/200, range 20/40-20/800) and 559 microm (range 333-689 microm), respectively. After treatment, median vision improved to LogMAR 0.544 (Snellen 20/70, range 20/40-20/1000) (P = 0.13). Vision improved or remained stable in six of seven eyes. Median foveal thickness at final follow-up was 436 microm (range 259-623 microm) (P = 0.15). Foveal thickness decreased or remained stable in all eyes.

CONCLUSION

The addition of IVTA to PRP in the treatment of eyes with high-risk PDR and CSMO may prevent PRP-induced foveal thickening and loss of vision.

摘要

目的

评估玻璃体内注射曲安奈德(IVTA)联合全视网膜光凝(PRP)对合并高危增殖性糖尿病视网膜病变(PDR)和临床显著性黄斑水肿(CSMO)患者视力(VA)和黄斑中心凹厚度的影响。

方法

本回顾性干预性病例系列研究纳入了7只被诊断为同时患有高危PDR和CSMO的眼睛,这些眼睛接受了PRP治疗以及单次4mg的IVTA注射。主要观察指标为治疗前及整个随访期间通过光学相干断层扫描(OCT)测量的VA和黄斑中心凹厚度。

结果

中位随访时间为301天(范围180 - 715天)。7只眼中有4只眼有黄斑中心凹厚度数据。联合治疗前,中位LogMAR(最小分辨角对数)视力和中位黄斑中心凹厚度分别为1(Snellen 20/200,范围20/40 - 20/800)和559微米(范围333 - 689微米)。治疗后,中位视力改善至LogMAR 0.544(Snellen 20/70,范围20/40 - 20/1000)(P = 0.13)。7只眼中有6只眼视力改善或保持稳定。末次随访时中位黄斑中心凹厚度为436微米(范围259 - 623微米)(P = 0.15)。所有眼中黄斑中心凹厚度均降低或保持稳定。

结论

在治疗高危PDR和CSMO的眼睛时,PRP联合IVTA可能预防PRP引起的黄斑中心凹增厚和视力丧失。

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