Sabet-Peyman E Jason, Nguyen Quan Dong, Do Diana V
Retina Division, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Ophthalmic Surg Lasers Imaging. 2009 Jul-Aug;40(4):413-5. doi: 10.3928/15428877-20096030-12.
A 63-year-old man with decreased vision due to postsurgical chronic cystoid macular edema that was recalcitrant to topical nonsteroidal anti-inflammatory drops had resolution of cystoid macular edema after intravitreal triamcinolone injection. However, 3 months later he developed increased intraocular pressure and a recurrence of the cystoid macular edema. Intravitreal bevacizumab was administered and optical coherence tomography revealed worsening of the cystoid macular edema 1 month after the injection. Chronic cystoid macular edema that does not respond to topical nonsteroidal antiinflammatory drops may resolve with intravitreal triamcinolone but not with bevacizumab. The current case demonstrates that some cystoid macular edema may not be responsive to vascular endothelial growth factor blockade alone. Further studies are needed to evaluate the pathogenesis of cystoid macular edema and determine whether vascular endothelial growth factor blockade should be included in treatment modalities for this condition.
一名63岁男性，因手术后慢性黄斑囊样水肿导致视力下降，局部使用非甾体类抗炎滴眼液治疗无效，玻璃体内注射曲安奈德后黄斑囊样水肿消退。然而，3个月后他出现眼压升高，黄斑囊样水肿复发。给予玻璃体内注射贝伐单抗，注射1个月后光学相干断层扫描显示黄斑囊样水肿加重。对局部非甾体类抗炎滴眼液无反应的慢性黄斑囊样水肿，玻璃体内注射曲安奈德可能有效，但注射贝伐单抗无效。本病例表明，某些黄斑囊样水肿可能单独对血管内皮生长因子阻断无反应。需要进一步研究来评估黄斑囊样水肿的发病机制，并确定血管内皮生长因子阻断是否应纳入该病的治疗方式。
