玻璃体内曲安奈德作为急性视网膜坏死治疗的辅助手段。
Intravitreal triamcinolone acetonide as an adjuvant in the management of acute retinal necrosis.
机构信息
L V Prasad Eye Institutes, GMRV Campus, Visakhapatnam, India.
L V Prasad Eye Institutes, GMRV Campus, Visakhapatnam, India.
出版信息
Can J Ophthalmol. 2014 Jun;49(3):279-82. doi: 10.1016/j.jcjo.2014.03.010.
OBJECTIVE
To determine the role of intravitreal triamcinolone acetonide (IVTA) as an adjuvant in the management of acute retinal necrosis (ARN).
DESIGN
Interventional case series.
PARTICIPANTS
Four eyes of 4 patients diagnosed with ARN were studied.
METHODS
This pilot case series included 4 patients who presented with clinical features suggestive of ARN. IVTA was injected 1 to 2 weeks after initiation of antiviral therapy and concurrent usage of oral corticosteroids. The disease course and clinical outcome were observed. The patients received additional treatment depending on the sequelae of ARN.
RESULTS
Signs of reduction in vitritis and resolution of retinitis were observed as early as 1 week after IVTA was administered. In all 4 patients, inflammation promptly resolved with no untoward effects like raised intraocular pressure or worsening of the retinitis. A final visual acuity of 20/40 or better was achieved in 3 of 4 patients after appropriate treatment of ARN-related complications.
CONCLUSIONS
Intravitreal triamcinolone under antiviral cover could be a useful adjunct to systemic steroids in the treatment of ARN.
目的
探讨玻璃体内曲安奈德（IVTA）作为辅助治疗急性视网膜坏死（ARN）的作用。
设计
干预性病例系列研究。
参与者
4 例 ARN 患者的 4 只眼纳入研究。
方法
本病例系列研究纳入了 4 例具有 ARN 临床特征的患者。在开始抗病毒治疗和联合使用口服皮质类固醇后 1 至 2 周，给予 IVTA 注射。观察疾病过程和临床结果。根据 ARN 的后遗症，患者接受了额外的治疗。
结果
IVTA 治疗后 1 周内即可观察到玻璃体炎症减轻和视网膜病变消退的迹象。4 例患者的炎症均迅速消退，无眼压升高或视网膜病变恶化等不良反应。经过适当治疗 ARN 相关并发症后，4 例患者中有 3 例最终视力达到 20/40 或更好。
结论
在抗病毒药物的保护下，玻璃体内注射曲安奈德可能是全身性皮质类固醇治疗 ARN 的有效辅助手段。
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