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玻璃体内及Tenon囊下注射曲安奈德治疗视网膜色素变性相关的黄斑囊样水肿

Intravitreal and subtenon depot triamcinolone as treatment of retinitis pigmentosa associated cystoid macular edema.

作者信息

Barge Sidnei, Rothwell Renata, Sepúlveda Paula, Agrelos Luís

机构信息

Department of Ophthalmology, Vila Nova Gaia/Espinho Hospital, Rua Conceição Fernandes, 4434-502 Vila Nova Gaia, Portugal.

出版信息

Case Rep Ophthalmol Med. 2013;2013:591681. doi: 10.1155/2013/591681. Epub 2013 Dec 23.

Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/562a/3885263/eb262d9624dd/CRIM.OPHMED2013-591681.001.jpg

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