Qu Yi, Liu Xin-Shu, Liang An-Yi, Xiao Jun-Yan, Zhao Chan, Gao Fei, Zhang Mei-Fen
Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Department of Ophthalmology, the Fourth People's Hospital of Shenyang, Shenyang 110031, Liaoning Province, China.
Int J Ophthalmol. 2020 Jul 18;13(7):1087-1091. doi: 10.18240/ijo.2020.07.11. eCollection 2020.
To evaluate the efficacy and safety of subconjunctival triamcinolone acetonide (TA) injections for treating uveitic macular edema (UME).
This retrospective case series study included patients with UME who received subconjunctival TA injections with a minimum follow-up period of 6mo. The main outcome measure was central macular thickness (CMT). The secondary outcome measures included best-corrected visual acuity (BCVA), recurrence rate and intraocular pressure (IOP).
In total, 65 patients (80 eyes), mainly including idiopathic uveitis in 33 patients (50.77%) and Vogt-Koyanagi-Harada (VKH) syndrome in 19 patients (29.23%), were enrolled in this study. The mean CMT decreased from 457.6±173.0 µm at baseline to 325.9±176.8, 302.7±148.2, 332.2±177.3 and 270.6±121.6 µm at 1-, 2-, 3- and 6-months postinjection, respectively (all <0.001). BCVA increased from logMAR 0.5±0.3 at baseline to logMAR 0.4±0.3, 0.4±0.3, 0.4±0.4 and 0.4±0.3 at the 1-, 2-, 3- and 6-months postinjection visits, respectively (all <0.001). Twenty-one (21/80, 26.25%) eyes underwent relapse of UME within 6mo. A total of 20/80 (25%) eyes exhibited elevated IOPs, of which 13 eyes were controlled with topical IOP-lowering agents and 7 eyes underwent surgical removal of subconjunctival TA deposit.
Subconjunctival TA injections appear to be safe and effective for UME.
评估结膜下注射曲安奈德(TA)治疗葡萄膜炎性黄斑水肿(UME)的疗效和安全性。
这项回顾性病例系列研究纳入了接受结膜下TA注射且随访期至少为6个月的UME患者。主要观察指标为中心黄斑厚度(CMT)。次要观察指标包括最佳矫正视力(BCVA)、复发率和眼压(IOP)。
本研究共纳入65例患者(80只眼),主要包括33例(50.77%)特发性葡萄膜炎和19例(29.23%)Vogt-小柳-原田(VKH)综合征患者。平均CMT从基线时的457.6±173.0 µm分别降至注射后1、2、3和6个月时的325.9±176.8、302.7±148.2、332.2±177.3和270.6±121.6 µm(均P<0.001)。BCVA从基线时的logMAR 0.5±0.3分别提高至注射后1、2、3和6个月时的logMAR 0.4±0.3、0.4±0.3、0.4±0.4和0.4±0.3(均P<0.001)。21只眼(21/80,26.25%)在6个月内UME复发。共有20只眼(20/80,25%)眼压升高,其中13只眼通过局部降眼压药物得到控制,7只眼接受了结膜下TA沉积物的手术清除。
结膜下注射TA治疗UME似乎安全有效。