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玻璃体内及眶底注射曲安奈德对活动性非感染性葡萄膜炎患者眼内炎症的影响

[Effect of intravitreal and orbital floor triamcinolone acetonide injection on intraocular inflammation in patients with active non-infectious uveitis].

作者信息

Roesel M, Gutfleisch M, Heinz C, Heimes B, Zurek-Imhoff B, Heiligenhaus A

机构信息

Augenabteilung, St. Franziskus Hospital, Hohenzollernring 74, Münster.

出版信息

Klin Monbl Augenheilkd. 2009 Feb;226(2):110-4. doi: 10.1055/s-2008-1027762. Epub 2009 Feb 10.

Abstract

BACKGROUND

Currently, triamcinolone acetonide (TA) is frequently used to treat inflammation in non-infectious uveitis. The aim of this study was to compare the effect of TA on intraocular inflammation after a single intravitreal or orbital floor injection of the drug in patients with non-infectious uveitis.

PATIENTS AND METHODS

This was a monocentre, retrospective study in 114 eyes (103 patients). Twenty eyes were treated with intravitreal and 94 eyes with orbital floor TA. The main outcome measure was cells in the anterior chamber and anterior vitreous. Secondary outcome measures included protein accumulation in the aqueous humor (according to laser-flare photometry), best-corrected visual acuity, and complications. Follow-up evaluations were performed at 1, 3, and 6 months after TA injection.

RESULTS

After either intravitreal or orbital floor TA injection, the intraocular inflammation in the anterior chamber and vitreous decreased (p < 0.001, for both administration forms, and at all follow-up time points). Laser-flare values decreased in both groups. One month after injection, the visual acuity in the intravitreally treated patients was increased (p < 0.01), whereas the poor visual acuity persisted in the orbital floor group. The effect on macular oedema after intravitreal TA was better than in the orbital floor group (p < 0.01). Progression and increased cataract incidence were detected in 50 % after intravitreal and in 29 % after orbital floor TA.

CONCLUSIONS

After both intravitreal and orbital floor TA injection, the intraocular inflammation decreased. The effect of intravitreal TA on macular oedema and visual acuity was better than that of orbital floor TA, but intraocular pressure elevation and progressive cataract were more often observed in this group.

摘要

背景

目前,曲安奈德(TA)常用于治疗非感染性葡萄膜炎的炎症。本研究的目的是比较单次玻璃体内或眶底注射TA药物对非感染性葡萄膜炎患者眼内炎症的影响。

患者和方法

这是一项在114只眼(103例患者)中进行的单中心回顾性研究。20只眼接受玻璃体内TA治疗,94只眼接受眶底TA治疗。主要观察指标是前房和前部玻璃体中的细胞。次要观察指标包括房水中的蛋白质积聚(根据激光散射光度法)、最佳矫正视力和并发症。在TA注射后1、3和6个月进行随访评估。

结果

玻璃体内或眶底注射TA后,前房和玻璃体中的眼内炎症均减轻(两种给药方式在所有随访时间点均p<0.001)。两组的激光散射值均降低。注射后1个月,玻璃体内治疗患者的视力提高(p<0.01),而眶底组患者的视力仍较差。玻璃体内注射TA后对黄斑水肿的效果优于眶底组(p<0.01)。玻璃体内注射TA后50%的患者出现病情进展和白内障发病率增加,眶底注射TA后为29%。

结论

玻璃体内和眶底注射TA后,眼内炎症均减轻。玻璃体内注射TA对黄斑水肿和视力的效果优于眶底注射TA,但该组更常观察到眼压升高和白内障进展。

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