玻璃体内注射曲安奈德联合激光光凝治疗视网膜分支静脉阻塞后持续性黄斑水肿的眼睛

Combined intravitreal triamcinolone injection and laser photocoagulation in eyes with persistent macular edema after branch retinal vein occlusion.

作者信息

Riese Juliane, Loukopoulos Vlassis, Meier Cornelia, Timmermann Melanie, Gerding Heinrich

机构信息

Department of Retinology, Augenzentrum Klinik Pallas, Louis-Giroud-Strasse 20, CH-4600, Olten, Switzerland.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2008 Dec;246(12):1671-6. doi: 10.1007/s00417-008-0898-0. Epub 2008 Aug 16.

DOI:10.1007/s00417-008-0898-0

PMID:18709384

Abstract

BACKGROUND

To determine the efficacy of combined intravitreal triamcinolone (TA) injection and laser photocoagulation in persistent macular edema after branch retinal vein occlusion (BRVO).

METHODS

Follow-up analysis of a case series of 24 patients with macular edema after BRVO (15 of 24 non-ischaemic, 9 of 24 ischaemic). Patients received an intravitreal injection of 4 mg TA followed by laser photocoagulation within the previously edematous area, applied in one or two sessions. Standardized clinical examinations included best corrected visual acuity testing, anterior and posterior segment biomicroscopy, intraocular pressure, and optical coherence tomography (OCT). Fluorescein angiography was performed before treatment and 3 and 6 months later.

RESULTS

Median visual acuity improved significantly from 0.58 logMAR (95%-confidence interval (KI): 0.54-0.75, decimal 0.27) at baseline to 0.41 logMAR (KI: 0.37-0.64, decimal 0.39) at 1 month (p = 0.001), 0.33 logMAR (KI: 0.32-0.62, decimal 0.47) at 3 months (p = 0.002), and 0.41 logMAR (KI: 0.33-0.67, decimal 0.39) at 6 months (p = 0.016). A gain of one or more logarithmic lines was evaluated in 16/24 eyes (67 %) and a gain of 3 lines or more in 8/24 eyes (33 %) at 6 months. Three eyes had lost more than 1 line during the follow-up period. Median change of visual acuity at 6 months was +2.0 lines (KI: 0.2-2.4). Median central foveal thickness (OCT-CFT) was 423 microm (KI: 378-456, n = 24) at baseline and decreased to 270 microm (KI: 249-311, n = 24) at 1 month (p < 0.0001), 265 microm (KI: 254-344, n = 24) at 3 months (p < 0.0001), and 266 microm (KI: 259-365, n = 18) at 6 months (p = 0.001).

CONCLUSIONS

Macular edema after BRVO can effectively be treated by a combination of intravitreal TA injection and subsequent laser photocoagulation. During a 6-month follow-up this combination treatment resulted in a significant reduction of central foveal thickness and improvement of visual acuity.

摘要

背景

确定玻璃体内注射曲安奈德（TA）联合激光光凝治疗视网膜分支静脉阻塞（BRVO）后持续性黄斑水肿的疗效。

方法

对24例BRVO后黄斑水肿患者（24例中的15例为非缺血性，24例中的9例为缺血性）进行病例系列随访分析。患者接受4mg TA玻璃体内注射，随后在先前水肿区域进行一或两次激光光凝治疗。标准化临床检查包括最佳矫正视力测试、眼前段和后段生物显微镜检查、眼压和光学相干断层扫描（OCT）。在治疗前以及治疗后3个月和6个月进行荧光素血管造影。

结果

中位视力从基线时的0.58 logMAR（95%置信区间（KI）：0.54 - 0.75，小数0.27）显著改善至1个月时的0.41 logMAR（KI：0.37 - 0.64，小数0.39）（p = 0.001），3个月时为0.33 logMAR（KI：0.32 - 0.62，小数0.47）（p = 0.002），6个月时为0.41 logMAR（KI：0.33 - 0.67，小数0.39）（p = 0.016）。6个月时，24只眼中有16只（67%）视力提高了1个或更多对数行，8只（33%）视力提高了3行或更多。随访期间有3只眼视力下降超过1行。6个月时视力的中位变化为+2.0行（KI：0.2 - 2.4）。基线时中央凹厚度（OCT - CFT）中位数为423微米（KI：378 - 456，n = 24），1个月时降至270微米（KI：249 - 311，n = 24）（p < 0.0001），3个月时为265微米（KI：254 - 344，n = 24）（p < 0.0001），6个月时为266微米（KI：259 - 365，n = 18）（p = 0.001）。