Zhang Kaiyan, Chen Yingying, Sun Xuyang, Zhong Qionglei, Lin Lin, Gao Yuan, Hong Fanlin
Department of Ophthalmology, Hainan General Hospital, Haikou, China.
Medicine (Baltimore). 2018 Sep;97(39):e12464. doi: 10.1097/MD.0000000000012464.
To investigate the clinical efficiency of periocular triamcinolone acetonide (TA) injection for treating polypoidal choroidal vasculopathy (PCV) concurrent with hemorrhagic retinal detachment (HRD).Twenty-two cases confirmed with PCV concurrent with HRD characterized by massive subretinal hemorrhage and exudation presented to our department from January 2015 to May 2017 were included in this study. The initial vision varied from counting finger to 0.2. All cases were randomly divided into TA group (n = 12), which received periocular TA injection per month, and anti-VEGF group (n = 10), which were treated by anti-VEGF intravitreous injection per month. The patients were followed up for 6 months, in which fundus examination and visual acuity along with optical coherence tomography (OCT) were carried out.The treatment effect is divided into the following categories. Cure was defined as the elimination of subretinal hemorrhage and exudation accompanied by retinal edema and choroidal neovascularization (CNV) extinction and rise of visual acuity. Improvement was characterized by alleviation of subretinal hemorrhage and exudation accompanied by retinal edema and CNV reduction and rise of visual acuity. Ineffective means remained subretinal hemorrhage and exudation in fundus and no improvement of visual acuity, and polypoid lesions in OCT images. Among the 12 cases in TA group, 1 case was treated by periocular injection of TA twice, and 11 cases were treated by 3 times injection. After that, 3 cases (25%) were cured, 8 cases (66.7%) got improvement, and only 1 case (8.3%) showed no response. Although among 10 cases in the anti-VEGF group, 3 cases were treated by anti-VEGF intravitreous injection twice. Seven cases were treated by 3 times injection. After that, 4 cases (40%) got improvement, and the other 6 case (60%) showed no response. All patients showed no recurrence in the 6-month follow-up. No complications were noticed under periocular injection or intravitreous injection.Periocular TA injection is effective for treating PCV concurrent with HRD.
探讨眼周注射曲安奈德（TA）治疗息肉样脉络膜血管病变（PCV）合并出血性视网膜脱离（HRD）的临床疗效。本研究纳入了2015年1月至2017年5月期间在我科就诊的22例确诊为PCV合并HRD的患者，其特征为大量视网膜下出血和渗出。初始视力从指数到0.2不等。所有病例随机分为TA组（n = 12），每月接受眼周TA注射；抗VEGF组（n = 10），每月接受抗VEGF玻璃体腔注射治疗。对患者进行6个月的随访，期间进行眼底检查、视力检查以及光学相干断层扫描（OCT）检查。治疗效果分为以下几类。治愈定义为视网膜下出血和渗出消失，伴有视网膜水肿消退、脉络膜新生血管（CNV）消失以及视力提高。改善表现为视网膜下出血和渗出减轻，伴有视网膜水肿减轻、CNV减少以及视力提高。无效是指眼底仍存在视网膜下出血和渗出，视力无改善，且OCT图像中有息肉样病变。TA组12例患者中，1例接受了2次眼周TA注射，11例接受了3次注射。之后，3例（25%）治愈，8例（66.7%）改善，仅1例（8.3%）无反应。抗VEGF组10例患者中，3例接受了2次抗VEGF玻璃体腔注射，7例接受了3次注射。之后，4例（40%）改善，另外6例（60%）无反应。所有患者在6个月的随访中均未复发。眼周注射或玻璃体腔注射均未发现并发症。眼周TA注射治疗PCV合并HRD有效。
