Matsuura Kazuki, Uotani Ryu, Terasaka Yuki
Nojima Hospital, Tottori, Japan.
Clin Ophthalmol. 2013;7:1525-8. doi: 10.2147/OPTH.S49226. Epub 2013 Jul 24.
We report the successful treatment of a case of cystoid macular edema (CME) associated with topical tafluprost, which was accompanied by serous retinal detachment (SRD).
A 78-year-old woman underwent intraocular lens suture surgery, including anterior vitreous cutting, for crystalline lens dislocation in the right eye. Tafluprost was initiated 12 weeks after surgery. Intraocular pressure (IOP) was controlled at 10-14 mmHg. Visual acuity remained at 20/40-30/40. However, the patient complained of blurred vision (20/200) 9 months after surgery. CME accompanied by SRD was identified by optical coherence tomography (OCT) and treated with subtenon triamcinolone injection. Visual acuity rapidly increased to 20/50, and the volume of SRD decreased in a few days. Discontinuation of tafluprost and initiation of diclofenac eye drops improved visual acuity to 20/40 and resulted in improved OCT findings within a few weeks. Three months after injection, tafluprost was resumed along with diclofenac. No recurrence of CME occurred over the following 3 months, and IOP was controlled at 10-15 mmHg.
SRD is considered to be a symptom of treatment-resistant CME, which may lead to poor visual acuity after recovery. In such cases, subtenon triamcinolone injection should be strongly considered at an early stage.
我们报告了一例成功治疗与局部使用他氟前列素相关的黄斑囊样水肿（CME）病例，该病例伴有浆液性视网膜脱离（SRD）。
一名78岁女性因右眼晶状体脱位接受了包括前部玻璃体切割在内的人工晶状体缝合手术。术后12周开始使用他氟前列素。眼压（IOP）控制在10 - 14 mmHg。视力维持在20/40 - 30/40。然而，患者在术后9个月抱怨视力模糊（20/200）。通过光学相干断层扫描（OCT）确诊为伴有SRD的CME，并接受了球周注射曲安奈德治疗。视力迅速提高到20/50，且SRD的体积在几天内减小。停用他氟前列素并开始使用双氯芬酸钠滴眼液后，视力提高到20/40，并在几周内使OCT检查结果得到改善。注射后三个月，他氟前列素与双氯芬酸钠同时恢复使用。在接下来的3个月里未出现CME复发，眼压控制在10 - 15 mmHg。
SRD被认为是难治性CME的一种症状，如果恢复后可能导致视力不佳。在这种情况下，应在早期强烈考虑球周注射曲安奈德。
