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结膜下注射曲安奈德治疗葡萄膜炎性黄斑水肿的安全性和有效性:31例回顾性研究

[Safety and efficacy of subconjunctival triamcinolone injections in the management of uveitic macular edema: retrospective study of thirty-one cases].

作者信息

Bleriot A, Couret C, Le Meur G, Lebranchu P, Weber M

机构信息

Service d'ophtalmologie, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France.

Service d'ophtalmologie, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France.

出版信息

J Fr Ophtalmol. 2014 Oct;37(8):599-604. doi: 10.1016/j.jfo.2014.04.010. Epub 2014 Sep 8.

DOI:10.1016/j.jfo.2014.04.010
PMID:25199486
Abstract

Triamcinolone acetonide (Kenacort) is a corticosteroid that can be administrated by subconjunctival injection, with an extended release for up to three months. Our retrospective study aims to analyze safety and efficacy of subconjunctival triamcinolone injections in the treatment of uveitic macular edema. We included 31 eyes of 30 patients, who had one or several injections. We studied the progression of visual acuity, central macular thickness by optical coherence tomography (OCT), intraocular pressure, and presence or absence of cataract, on the day of injection (T0), and at 1, 3, 6 and 12 months after injection. Twenty-one patients had only one injection; 10 patients had 2. The 12-month follow-up showed an improvement in visual acuity with an initial mean of 0.36 ± 0.27 logMAR to 0.23 ± 0.33 logMAR at 3 months of follow-up (P<0.0004), and to 0.24 ± 0.21 logMAR at 12 months (P=0.0371), for a two-line improvement. A decrease in mean central macular thickness was measured by OCT, from a mean of 444 ± 112 μm (0.24 ± 0.11 logSD-OCT) at T0 to 355 ± 103 μm (0.14 $ ± 0.10 logSD-OCT) at 3 months (P=0.0002). We did not find a significant increase in intraocular pressure, and we diagnosed one cataract during follow-up but this occurred in the uninjected eye as well. Subconjunctival injection of triamcinolone acetonide is a safe and effective treatment of macular edema related to uveitis. Initial clinical monitoring is necessary to detect iatrogenic events.

摘要

曲安奈德(康宁克通)是一种皮质类固醇,可通过结膜下注射给药,缓释期长达三个月。我们的回顾性研究旨在分析结膜下注射曲安奈德治疗葡萄膜炎性黄斑水肿的安全性和有效性。我们纳入了30例患者的31只眼,这些患者接受了一次或多次注射。我们研究了注射当天(T0)以及注射后1、3、6和12个月时的视力进展、光学相干断层扫描(OCT)测量的中心黄斑厚度、眼压以及白内障的有无。21例患者仅接受了一次注射;10例患者接受了2次注射。12个月的随访显示,视力有所改善,初始平均logMAR为0.36±0.27,随访3个月时为0.23±0.33(P<0.0004),12个月时为0.24±0.21(P=0.0371),提高了两行。OCT测量显示中心黄斑平均厚度有所降低,从T0时的平均444±112μm(0.24±0.11 logSD-OCT)降至3个月时的355±103μm(0.14±0.10 logSD-OCT)(P=0.0002)。我们未发现眼压有显著升高,随访期间诊断出一例白内障,但未注射的眼睛也出现了白内障。结膜下注射曲安奈德是治疗与葡萄膜炎相关的黄斑水肿的一种安全有效的方法。需要进行初始临床监测以检测医源性事件。

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引用本文的文献

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