Choudhry Surbhit, Ghosh Sudipta
ICARE Eye Hospital and Postgraduate Institute, Glaucoma Research Centre, Noida, Uttar Pradesh, India.
Clin Exp Ophthalmol. 2007 Nov;35(8):713-8. doi: 10.1111/j.1442-9071.2007.01578.x.
To study the efficacy of intravitreal triamcinolone acetonide (IVTA) versus posterior subtenon triamcinolone acetonide (PSTA) in bilateral macular oedema secondary to idiopathic intermediate uveitis.
In a prospective, interventional case series, 10 patients (20 eyes) with bilateral uveitic macular oedema were included. Patients underwent fundus fluorescein angiography, record of visual acuity and intraocular pressure (IOP). Patients received IVTA 4 mg/0.1 mL in one eye and PSTA 20 mg/0.5 mL in the fellow eye at an interval of > or =4 weeks. The outcome measures were record of IOP, best corrected visual acuity and angiographic resolution of cystoid macular oedema at 3 and 6 months.
The mean pre-intervention IOP at baseline between the IVTA and the PSTA group was comparable. At 1 week, the mean IOP recorded was greater in the eyes that received IVTA than those that received PSTA (P < 0.001). However, at 1- and 3-month follow up, the mean IOP between the two groups was similar. Best corrected visual acuity of > or =6/12 achieved at 3 and 6 months in the IVTA and PSTA group was comparable (77.8% vs. 44.4% [P = 0.14] and 88.9% vs. 77.8% [P = 0.53]). There was also no significant difference in angiographic resolution of cystoid macular oedema at 3 (P = 0.32) and 6 months (P = 0.53) between the two groups. Recurrence of macular oedema was seen in one and two eyes that received IVTA and PSTA, respectively, at 6 months.
Triamcinolone acetonide injection, whether administered intravitreally or via posterior subtenon route, is an effective treatment option in achieving complete anatomic and functional improvement in cases treated for macular oedema secondary to idiopathic intermediate uveitis.
研究玻璃体内注射曲安奈德（IVTA）与后Tenon囊下注射曲安奈德（PSTA）治疗特发性中间葡萄膜炎继发双侧黄斑水肿的疗效。
在一项前瞻性干预性病例系列研究中，纳入10例（20只眼）双侧葡萄膜炎性黄斑水肿患者。患者接受眼底荧光血管造影、视力和眼压（IOP）记录。患者一只眼接受4mg/0.1mL的IVTA，另一只眼接受20mg/0.5mL的PSTA，间隔≥4周。观察指标为3个月和6个月时的IOP记录、最佳矫正视力以及黄斑囊样水肿的血管造影消退情况。
IVTA组和PSTA组干预前基线时的平均IOP相当。在第1周，接受IVTA的眼的平均记录IOP高于接受PSTA的眼（P<0.001）。然而，在1个月和3个月随访时，两组间的平均IOP相似。IVTA组和PSTA组在3个月和6个月时达到最佳矫正视力≥6/12的情况相当（77.8%对44.4%[P=0.14]以及88.9%对77.8%[P=0.53]）。两组在3个月（P=0.32）和6个月（P=0.53）时黄斑囊样水肿的血管造影消退情况也无显著差异。在6个月时，接受IVTA和PSTA的眼分别有1只和2只出现黄斑水肿复发。
曲安奈德注射，无论是玻璃体内注射还是经后Tenon囊下途径给药，对于治疗特发性中间葡萄膜炎继发黄斑水肿的病例，在实现完全的解剖和功能改善方面都是一种有效的治疗选择。
