Wang Jia-Kang, Lin Wen-Chen
*MD Department of Ophthalmology, Far Eastern Memorial Hospital, Taipei, Taiwan (J-KW); Oriental Institute of Technology, Taipei, Taiwan (J-KW); and Department of Medicine, National Yang Ming University, Taipei, Taiwan (J-KW, W-CL).
Optom Vis Sci. 2013 Oct;90(10):e274-7. doi: 10.1097/OPX.0000000000000026.
To describe a case of X-linked retinoschisis with pseudophakic cystoid macular edema treated by posterior subtenon injection of triamcinolone acetonide.
The patient was a 60-year-old man. His best-corrected visual acuity (BCVA) was counting fingers in the right eye. Senile cataract was found with grade II nuclear sclerosis. Optical coherence tomography revealed foveoschisis with a central foveal thickness (CFT) of 545 μm. The patient underwent uneventful phacoemulsification and in-the-bag implantation of intraocular lens. Postoperative persistent cystoid macular edema was found, with CFT increased to 787 μm. The macular edema did not respond to topical corticosteroids and nonsteroidal anti-inflammatory drugs. Triamcinolone acetonide 20 mg was injected into the posterior subtenon space 10 weeks after the surgery. Macular cystic lesions dramatically disappeared 2 months after the injection, and CFT decreased to 171 μm, with accompanying inner/outer segment disruption. His BCVA also improved to 20/100. Macular edema or foveoschisis did not recur, and BCVA remained stable 1 year after the cataract operation.
Foveoschisis and pseudophakic cystoid macular edema disappeared after posterior subtenon injection of triamcinolone acetonide without recurrence during the 15-month follow-up period.
描述1例通过球后注射曲安奈德治疗的伴有人工晶状体眼黄斑囊样水肿的X连锁视网膜劈裂症病例。
患者为一名60岁男性。其右眼最佳矫正视力（BCVA）为指数。发现患有老年性白内障，核硬化Ⅱ级。光学相干断层扫描显示中心凹劈裂，中心凹厚度（CFT）为545μm。患者接受了顺利的白内障超声乳化吸除术及人工晶状体囊袋内植入术。术后发现持续性黄斑囊样水肿，CFT增至787μm。黄斑水肿对局部用皮质类固醇和非甾体抗炎药无反应。术后10周在球后间隙注射20mg曲安奈德。注射后2个月黄斑囊性病变显著消失，CFT降至171μm，伴有内/外节中断。其BCVA也提高到20/100。白内障手术后1年黄斑水肿或中心凹劈裂未复发，BCVA保持稳定。
球后注射曲安奈德后，中心凹劈裂和人工晶状体眼黄斑囊样水肿消失，在15个月的随访期内未复发。
