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40毫克球周注射曲安奈德、0.7毫克地塞米松植入物及2毫克玻璃体内注射曲安奈德后的高眼压症

Ocular hypertension following 40 mg sub-Tenon triamcinolone versus 0.7 mg dexamethasone implant versus 2 mg intravitreal triamcinolone.

作者信息

Kuley Brandon, Storey Philip P, Pancholy Maitri, Bello Nicholas, Murphy James, Goodman Jake, Wibbelsman Turner D, Obeid Anthony, Chiang Allen, Regillo Carl, Garg Sunir

机构信息

From the Mid Atlantic Retina, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA.

Austin Retina Associates, Austin, TX.

出版信息

Can J Ophthalmol. 2020 Dec;55(6):480-485. doi: 10.1016/j.jcjo.2020.06.021. Epub 2020 Aug 24.

Abstract

OBJECTIVE

To compare rates of ocular hypertension (OHT) in eyes receiving 40 mg sub-Tenon triamcinolone (STT), 0.7 mg dexamethasone implant (DEX), and 2 mg intravitreal triamcinolone (IVT).

METHODS

This study is a single-centre, retrospective case series. All patients receiving STT and DEX between 4/1/2014 and 3/1/2017 and IVT between 3/1/2012 and 3/1/2017 with a minimum of 3 months' follow-up were included. OHT was defined as an intraocular pressure (IOP) >24 mm Hg. Patients receiving any other form of topical, oral, or intravitreal steroid were excluded.

RESULTS

113 eyes from 104 patients in the STT group, 122 eyes from 109 patients in the DEX group, and 109 eyes from 103 patients in the IVT group were included. The mean number of injections for each eye was 1.7 in the STT group, 2.6 for the DEX group, and 2.8 for the IVT group (p < 0.001). Twenty eyes (17.7%) developed OHT in the STT group, 19 eyes (15.6%) developed OHT in the DEX group, and 14 eyes (12.8%) developed OHT in the IVT group (p = 0.60). IOP was controlled in all eyes with observation, topical IOP-lowering medication, or surgical intervention. The rate of incisional glaucoma surgery was 1.7% in the STT group, 1.6% in the DEX group, and 0% in the IVT group (p = 0.55).

CONCLUSIONS

The rate of OHT was similar across treatment groups. The proportion of OHT in patients with a history of glaucoma was no different from that in patients without a history of glaucoma. All cases were successfully managed with observation, medical treatment, or incisional surgery.

摘要

目的

比较接受40毫克球周注射曲安奈德(STT)、0.7毫克地塞米松植入剂(DEX)和2毫克玻璃体内注射曲安奈德(IVT)的眼睛发生高眼压(OHT)的几率。

方法

本研究为单中心回顾性病例系列研究。纳入2014年1月4日至2017年1月3日期间接受STT和DEX治疗以及2012年1月3日至2017年1月3日期间接受IVT治疗且随访至少3个月的所有患者。高眼压定义为眼压(IOP)>24毫米汞柱。排除接受任何其他形式局部、口服或玻璃体内类固醇治疗的患者。

结果

STT组纳入104例患者的113只眼,DEX组纳入109例患者的122只眼,IVT组纳入103例患者的109只眼。STT组每只眼平均注射次数为1.7次,DEX组为2.6次,IVT组为2.8次(p<0.001)。STT组20只眼(17.7%)发生高眼压,DEX组19只眼(15.6%)发生高眼压,IVT组14只眼(12.8%)发生高眼压(p = 0.60)。所有眼睛通过观察、局部降眼压药物或手术干预眼压均得到控制。STT组切口性青光眼手术率为1.7%,DEX组为1.6%,IVT组为0%(p = 0.55)。

结论

各治疗组高眼压发生率相似。有青光眼病史患者的高眼压比例与无青光眼病史患者无异。所有病例通过观察、药物治疗或切口手术均成功处理。

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