Department of Ophthalmology, the Johns Hopkins University School of Medicine, Baltimore, Maryland.
Department of Epidemiology, Center for Clinical Trials, the Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Department of Ophthalmology, Mount Sinai School of Medicine, New York, New York; Department of Medicine, Mount Sinai School of Medicine, New York, New York.
Am J Ophthalmol. 2011 Sep;152(3):441-448.e2. doi: 10.1016/j.ajo.2011.02.009. Epub 2011 Jun 8.
To describe the effectiveness of periocular corticosteroid injections in the treatment of cystoid macular edema (CME) complicating noninfectious uveitis.
Retrospective cohort study.
A total of 126 patients (156 eyes) were evaluated for presence of CME, visual acuity, intraocular pressure, degree of intraocular inflammation, and the presence of ocular complications. Main outcome measures included resolution of CME and visual acuity at the 1- and 3-month visits, failure of periocular injection therapy, and side effects.
Twenty-eight percent of the 156 eyes had anterior uveitis, 22% intermediate uveitis, and 31% panuveitis. Of these eyes, 53% demonstrated clinical resolution of CME at 1 month and 57% at 3 months after a single periocular corticosteroid injection. Forty eyes were treated with >1 periocular injection because the CME persisted 1 month after the first injection (1 additional injection in 21 eyes; 2 additional injections in 14 eyes; >2 additional injections in 5 eyes). For the 21 eyes treated with a second periocular corticosteroid injection, 81% had no CME 1 month after the second injection and 48% had no CME 3 months after the second injection. Twenty-three eyes (15%) failed periocular corticosteroid therapy. Of eyes initially responding to periocular injection, CME recurred in 53% (median time to recurrence = 20.2 weeks). A halving of the visual angle was observed in 52% and 57% at the 1- and 3-month visits after injection, respectively.
Fifty-three percent of eyes treated with a single periocular corticosteroid injection had clinical resolution of CME 1 month after the injection.
描述眼周皮质类固醇注射治疗非感染性葡萄膜炎合并囊样黄斑水肿（CME）的疗效。
回顾性队列研究。
共评估了 126 例（156 只眼）患者的 CME、视力、眼内压、眼内炎症程度以及眼部并发症的存在情况。主要观察指标包括：注射后 1 个月和 3 个月时 CME 的消退情况和视力、眼周注射治疗失败以及副作用。
156 只眼中，28%为前葡萄膜炎，22%为中间葡萄膜炎，31%为全葡萄膜炎。这些眼中，53%在单次眼周皮质类固醇注射后 1 个月时 CME 临床消退，57%在 3 个月时消退。40 只眼因 CME 在首次注射后 1 个月仍持续存在而接受了>1 次眼周注射治疗（21 只眼追加 1 次注射；14 只眼追加 2 次注射；5 只眼追加>2 次注射）。对于接受第 2 次眼周皮质类固醇注射的 21 只眼，81%在第 2 次注射后 1 个月时无 CME，48%在第 2 次注射后 3 个月时无 CME。23 只眼（15%）对眼周皮质类固醇治疗无效。在最初对眼周注射有反应的眼中，53%（复发中位时间=20.2 周）的 CME 复发。注射后 1 个月和 3 个月时，分别有 52%和 57%的眼视力下降一半。
53%接受单次眼周皮质类固醇注射治疗的眼在注射后 1 个月时 CME 临床消退。
