Department of Ophthalmology and Vision Science, University of California, Davis, Sacramento, California.
Department of Biomedical Engineering, Duke University, Durham, North Carolina.
Am J Ophthalmol. 2018 Feb;186:144-151. doi: 10.1016/j.ajo.2017.11.020. Epub 2017 Dec 2.
To evaluate choroidal and suprachoroidal changes following suprachoroidal injection of triamcinolone acetonide injectable suspension (CLS-TA), in eyes with macular edema due to retinal vein occlusion (RVO).
Prospective cohort study within a randomized, controlled phase 2 clinical trial.
Enhanced depth imaging optical coherence tomography (EDI-OCT) images were analyzed from 38 eyes of 38 treatment-naïve patients with macular edema due to RVO, enrolled in the prospective Suprachoroidal Injection of Triamcinolone Acetonide with Intravitreal Aflibercept in Subjects with Macular Edema Due to Retinal Vein Occlusion (TANZANITE) study who received either a suprachoroidal injection of CLS-TA with an intravitreal injection of aflibercept (combination arm) or only an intravitreal injection of aflibercept (monotherapy arm), followed by monthly intravitreal aflibercept injections in both arms based on pro re nata criteria.
Macular choroidal thickness measured to the outer choroidal vessel lumen (vascular choroidal thickness, VCT), outer choroid stroma (stromal choroidal thickness, SCT), or inner scleral border (total choroidal thickness, TCT) showed no significant changes over 3 months in both study arms (P = .231-.342). Eyes that received combination therapy showed a trend toward thickening of the suprachoroidal space (SCS) compared with monotherapy alone (13.4 μm vs 5.3 μm at 3 months; P = .077). In the 15 eyes that demonstrated a visible SCS at baseline, the SCS expanded significantly after suprachoroidal CLS-TA injection (16.2 μm to 27.8 μm at 3 months; P = .033).
Suprachoroidal injection of CLS-TA does not alter choroidal thickness in eyes with macular edema due to RVO, but may result in expansion of the SCS.
评估曲安奈德乙酰丙酮注射混悬液（CLS-TA）玻璃体内注射后脉络膜和脉络膜上腔的变化，研究对象为视网膜静脉阻塞（RVO）所致黄斑水肿患者。
前瞻性队列研究，为随机、对照的 2 期临床试验的一部分。
对 38 例 RVO 所致黄斑水肿且未经治疗的患者的 38 只眼进行前瞻性研究，这些患者均来自于曲安奈德乙酰丙酮玻璃体内注射联合玻璃体内注射阿柏西普治疗视网膜静脉阻塞所致黄斑水肿（TANZANITE）研究，这些患者随机分为玻璃体内注射 CLS-TA 联合玻璃体内注射阿柏西普（联合治疗组）或仅玻璃体内注射阿柏西普（单药治疗组）。两组患者均根据 pro re nata 标准每月接受玻璃体内注射阿柏西普治疗。
在两组研究中，用外脉络膜血管管腔（脉络膜血管厚度，VCT）、外脉络膜基质（脉络膜基质厚度，SCT）或内巩膜边界（总脉络膜厚度，TCT）测量的黄斑脉络膜厚度在 3 个月内均无明显变化（P=.231-.342）。与单药治疗相比，联合治疗组的脉络膜上腔（SCS）厚度有增厚趋势（3 个月时为 13.4μm 比 5.3μm；P=.077）。在基线时有可见 SCS 的 15 只眼中，SCS 在玻璃体内 CLS-TA 注射后显著扩张（3 个月时从 16.2μm 增加到 27.8μm；P=.033）。
玻璃体内注射 CLS-TA 不会改变 RVO 所致黄斑水肿患者的脉络膜厚度，但可能导致 SCS 扩张。
