单眼周注射甲泼尼龙和引流脉络膜上腔积液治疗孔源性视网膜脱离合并脉络膜脱离的效果。

The effect of single periocular injection of methylprednisolone and drainage of suprachoroidal fluid in the treatment of rhegmatogenous retinal detachment combined with choroidal detachment.

机构信息

The Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325027, China.

Xiamen Eye Center Affiliated to Xiamen University, Xiamen, 361000, China.

出版信息

Eye (Lond). 2019 Sep;33(9):1387-1392. doi: 10.1038/s41433-019-0420-4. Epub 2019 Apr 2.

DOI:10.1038/s41433-019-0420-4

PMID:30940887

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7002403/

Abstract

PURPOSE

In this study we compared the anatomic and functional outcomes of two steroid treatments on rhegmatogenous retinal detachment (RRD) combined with choroidal detachment (CD), namely treatment with oral prednisolone (1 mg/kg daily) for 3-7 days before vitrectomy or a single periocular injection of methylprednisolone (40 mg) 1-3 days before vitrectomy. We also analyzed the outcomes of the eyes with subsided CD and the eyes with persistent CD that underwent drainage of suprachoroidal fluids during the vitrectomy.

METHODS

This was a prospective randomized study. Seventy five eyes with RRD combined with CD were divided into 2 groups based on the two different treatment regimens as above. The eyes in each group were further divided into 2 subgroups (A: CD subsided eyes; B: CD persistent eyes) according to the response of CD to the treatment of steroids. Retinal reattachment rates were measured at 6 months after the removal of silicone oil.

RESULTS

At 6 months after silicone oil removal, the retinal reattachment rate was similar (p = 0.666) in the oral prednisolone group (91.7%, 33/36) and the periocular injection group (94.9%, 37/39). Similar retinal reattachment rates (p = 0.364) were also found in the CD subsided eyes (97.1%, 34/35) and the CD persistent eyes (90.0%, 36/40). The retinal reattachment rate was comparable among the subgroups (p = 0.395; oral prednisolone A group: 95.2%, 20/21; oral prednisolone B group: 86.7%, 13/15; periocular injection A group: 100%, 14/14; periocular injection B group: 92.0%, 23/25).

CONCLUSIONS

For RRD combined with CD, eyes treated with a single periocular injection of methylprednisolone (40 mg, 1-3 days before pars plana vitrectomy) combined with the drainage of suprachoroidal fluids during the surgery had similar anatomic and functional outcomes compared to the eyes treated with oral prednisolone for 3-7 days before vitrectomy.

摘要

目的

本研究比较了两种类固醇治疗方案对合并脉络膜脱离的孔源性视网膜脱离（RRD）的解剖和功能结局，即玻璃体切除术前 3-7 天口服泼尼松龙（1mg/kg 每日）或玻璃体切除术前 1-3 天单眼玻璃体内注射甲泼尼龙（40mg）。我们还分析了脉络膜脱离消退和接受玻璃体切除术中脉络膜上腔液引流的持续脉络膜脱离眼的治疗结果。

方法

这是一项前瞻性随机研究。根据上述两种不同的治疗方案，将 75 只合并脉络膜脱离的 RRD 眼分为两组。每组眼根据脉络膜脱离对类固醇治疗的反应进一步分为 2 个子组（A：脉络膜脱离消退眼；B：脉络膜脱离持续眼）。硅油取出 6 个月后测量视网膜复位率。

结果

硅油取出后 6 个月，口服泼尼松龙组（91.7%，33/36）和玻璃体内注射组（94.9%，37/39）的视网膜复位率相似（p=0.666）。脉络膜脱离消退眼（97.1%，34/35）和脉络膜脱离持续眼（90.0%，36/40）的视网膜复位率也相似（p=0.364）。各亚组间视网膜复位率无差异（p=0.395；口服泼尼松龙 A 组：95.2%，20/21；口服泼尼松龙 B 组：86.7%，13/15；玻璃体内注射 A 组：100%，14/14；玻璃体内注射 B 组：92.0%，23/25）。