Orii Yusuke, Gozawa Makoto, Takamura Yoshihiro, Takeuchi Yuko, Morioka Masakazu, Yamada Yutaka, Matsumura Takehiro, Sugimoto Masahiko, Inatani Masaru
Department of Ophthalmology, University of Fukui Faculty of Medical Sciences, Yoshida-gun, Japan.
Ophthalmology, Tokyo Dental College, Ichikawa General Hospital, Chiba, Japan.
BMJ Open Ophthalmol. 2021 Jan 8;6(1):e000620. doi: 10.1136/bmjophth-2020-000620. eCollection 2021.
To compare the intraocular pressure (IOP) after an intravitreal triamcinolone acetonide (IVTA) between vitrectomised and non-vitrectomised eyes in patients with diabetes and diabetic macular oedema (DME).
Retrospective comparative study.
Medical records of 157 patients (157 eyes) with type 2 diabetes who received IVTA for DME were reviewed, and the best-corrected visual acuity, IOP and optical central retinal thickness (CRT) were compared preoperatively, at 1, 4, 12 and 24 weeks after IVTA between the vitrectomised and non-vitrectomised groups.
IOP significantly increased at 1 (p<0.0001), 4 (p<0.0001), 8 (p<0.0001), 12 (p=0.0019), 16 (p=0.0006) and 20 weeks (p=0.0191) in the non-vitrectomised group, whereas a significant increase was only observed at 1 (p=0.0003) and 4 weeks (p=0.0006) in the vitrectomised group. ΔIOP, IOP changes from baseline, in the non-vitrectomised group was significantly higher than that in the vitrectomised group at 4 (p=0.0014), 8 (p=0.0081), 12 (p=0.0032) and 16 weeks (p=0.0038). No significant difference was observed in logMAR and CRT at any time point after IVTA between the two groups.
After an initial IVTA, increased IOP and ΔIOP from the baseline IOP were significantly more frequently observed in the non-vitrectomised than that in the vitrectomised group. IVTA is a safer and more effective treatment option for DME in vitrectomised than that in non-vitrectomised eyes.
比较糖尿病及糖尿病性黄斑水肿(DME)患者行玻璃体腔注射曲安奈德(IVTA)后,玻璃体切除眼与未行玻璃体切除眼的眼内压(IOP)。
回顾性对照研究。
回顾性分析157例2型糖尿病患者(157只眼)因DME接受IVTA治疗的病历资料,比较玻璃体切除组与未行玻璃体切除组术前、IVTA后1周、4周、12周及24周的最佳矫正视力、IOP及光学相干断层扫描中心视网膜厚度(CRT)。
未行玻璃体切除组在IVTA后1周(p<0.0001)、4周(p<0.0001)、8周(p<0.0001)、12周(p=0.0019)、16周(p=0.0006)及20周(p=0.0191)IOP显著升高,而行玻璃体切除组仅在1周(p=0.0003)及4周(p=0.0006)IOP显著升高。未行玻璃体切除组的ΔIOP(IOP相对于基线的变化)在4周(p=0.0014)、8周(p=0.0081)、12周(p=0.0032)及16周(p=0.0038)时显著高于行玻璃体切除组。两组在IVTA后任何时间点的logMAR及CRT均无显著差异。
初次IVTA后,未行玻璃体切除组较行玻璃体切除组IOP升高及ΔIOP相对于基线IOP升高的情况更常见。对于DME,IVTA用于玻璃体切除眼比未行玻璃体切除眼更安全、有效。