Seuthe A-M, Szurman P, Boden K T
Knappschaftsaugenklinik Sulzbach, An der Klinik 10, 66280, Sulzbach, Deutschland.
Universitätsaugenklinik Tübingen, Tübingen, Deutschland.
Ophthalmologe. 2017 Nov;114(11):1034-1037. doi: 10.1007/s00347-016-0425-3.
We report on a patient with postsurgical cystoid macular edema (CME) after phacoemulsification and multifocal intraocular lens (MIOL) implantation. At first, there was a very good reaction to intravitreal triamcinolone, inducing complete regression of the edema without increasing intraocular pressure (IOP). One year later the patient suffered from retinal detachment and was treated with vitrectomy, laser, and gas tamponade. Afterward, he developed macular pucker with edema. After surgical treatment with pucker peeling and intravitreal triamcinolone, the patient showed a steroid response and an increase IOP. Postoperatively, there was a recurrence of CME. A coincidental administration of a steroid injection intramuscularly by the general practitioner achieved a prompt reduction of the CME without increasing IOP. This case shows that an initially good reaction to triamcinolone without increasing IOP does not rule out a future steroid response, and that a potential treatment option for CME in patients with a known steroid response could consist of intramuscularly injected steroids.
我们报告了一例白内障超声乳化吸除联合多焦点人工晶状体植入术后发生囊样黄斑水肿（CME）的患者。起初，患者对玻璃体内注射曲安奈德反应良好，水肿完全消退且未导致眼压升高。一年后，患者发生视网膜脱离，接受了玻璃体切除术、激光治疗和气液填充。此后，他出现黄斑皱襞伴水肿。在进行黄斑皱襞剥除术及玻璃体内注射曲安奈德的手术治疗后，患者出现了类固醇反应及眼压升高。术后，CME复发。全科医生偶然一次肌内注射类固醇注射剂后，CME迅速减轻且眼压未升高。该病例表明，起初对曲安奈德反应良好且未导致眼压升高，并不排除日后出现类固醇反应的可能，对于已知有类固醇反应的CME患者，一种潜在的治疗选择可能是肌内注射类固醇。
