Barge Sidnei, Rothwell Renata, Sepúlveda Paula, Agrelos Luís
Department of Ophthalmology, Vila Nova Gaia/Espinho Hospital, Rua Conceição Fernandes, 4434-502 Vila Nova Gaia, Portugal.
Case Rep Ophthalmol Med. 2013;2013:591681. doi: 10.1155/2013/591681. Epub 2013 Dec 23.
We present a case of retinitis pigmentosa (RP) related cystoid macular edema (CME) refractory to oral acetazolamide and topical ketorolac that was treated with intravitreal and subtenon depot triamcinolone. A 32-year-old male with RP presented with complaints of bilateral decrease in visual acuity. His best-corrected visual acuity (BCVA) was 20/50 in the right eye and 20/100 in the left eye. After being informed of the available treatment options, the patient received bilateral intravitreal injection triamcinolone. The patient's BCVA improved to 20/40 in the right eye and 20/50 in the left eye and the CME was resorbed. However, 5 months after the injection in the left eye and two months in the right eye, visual acuity decreased due to recurrence of CME. We performed a second intravitreal injection in the left eye with improvement of visual and anatomic results, but we observed a recurrence of CME. Afterwards, we treated the patient with subtenon depot triamcinolone in both eyes, with the result that there was no recurrence after 4 months in OD or after 3 months in OS. We conclude that intravitreal and subtenon depot triamcinolone appear to provide at least temporary benefit in refractory CME as regards the improvement of visual acuity.
我们报告一例视网膜色素变性(RP)相关的黄斑囊样水肿(CME),该患者对口服乙酰唑胺和局部应用酮咯酸治疗无效,随后接受了玻璃体内及Tenon囊下注射曲安奈德治疗。一名32岁患有RP的男性患者,主诉双眼视力下降。他的最佳矫正视力(BCVA)右眼为20/50,左眼为20/100。在被告知可用的治疗方案后,该患者接受了双眼玻璃体内注射曲安奈德。患者的BCVA右眼提高到20/40,左眼提高到20/50,且CME消退。然而,左眼注射后5个月,右眼注射后2个月,由于CME复发,视力下降。我们对左眼进行了第二次玻璃体内注射,视力和解剖学结果均有改善,但我们观察到CME再次复发。之后,我们对患者双眼进行Tenon囊下注射曲安奈德,结果右眼4个月后、左眼3个月后均未复发。我们得出结论,就视力改善而言,玻璃体内及Tenon囊下注射曲安奈德似乎至少能为难治性CME提供暂时的益处。