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单次低剂量脉络膜上腔注射曲安奈德治疗非感染性后葡萄膜炎继发黄斑水肿

Single Low-dose Suprachoroidal Triamcinolone Acetonide Injection in Macular Edema Secondary to Noninfectious Posterior Uveitis.

作者信息

Anand Abhishek, Sinha Shivani, Gupta Abhishek, Shree Srishtee, Ambasta Anita, Sinha Bibhuti P, Azad Rajvardhan

机构信息

Department of Ophthalmology, Regional Institute of Ophthalmology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India.

出版信息

Middle East Afr J Ophthalmol. 2024 Jan 22;30(1):6-12. doi: 10.4103/meajo.meajo_78_21. eCollection 2023 Jan-Mar.

Abstract

PURPOSE

The purpose was to study the anatomical and functional outcome following single low-dose suprachoroidal triamcinolone acetonide (LD-SCTA) (2 mg) injection in noninfectious posterior uveitis.

METHODS

Eleven patients with macular edema (ME) more than 280 μ secondary to noninfectious uveitis were included in the study. A single LD-SCTA (0.5 ml) injection was performed in the study eye with the help of a novel suprachoroidal microneedle (Pricon, Iscon Surgicals, Jodhpur, Rajasthan, India). The study parameters were noted at 4 and 12 weeks post LD-SCTA injection.

RESULTS

Ten of 11 patients had a significant decrease in central macular thickness (CMT). The mean CMT measurement at baseline was 513.6 ± 191.73 μm for the 10 patients who responded to the treatment, which reduced significantly to 265.1 ± 34.72 μm ( < 0.003) and 260.6 ± 34.72 μm ( < 0.002) at 4 and 12 weeks, respectively. The mean best-corrected visual acuity (BCVA) at baseline was 0.84 ± 0.41 logMAR unit which improved to 0.52 ± 0.33 ( < 0.001) and 0.25 ± 0.22 ( < 0.000) at weeks 4 and 12, respectively. The mean intraocular pressure at baseline recorded was 16.36 ± 2.97 mmHg, 19.45 ± 4.80 mmHg ( = 0.06) at 4 weeks, and 17.27 ± 2.53 mmHg ( = 0.35) at 12 weeks. One eye which did not respond to LD-SCTA was a case of recurrent Vogt-Koyanagi-Harada disease.

CONCLUSION

Single LD-SCTA injection is efficacious in reducing CMT in ME, improving BCVA, and controlling the inflammation in noninfectious posterior uveitis. LD-SCTA can be used as a first-line therapy in noninfectious uveitis over other routes of steroid administration with a favorable outcome and safety profile.

摘要

目的

本研究旨在探讨单次低剂量脉络膜上腔注射曲安奈德(LD-SCTA,2mg)治疗非感染性后葡萄膜炎的解剖学和功能学转归。

方法

纳入11例继发于非感染性葡萄膜炎且黄斑水肿(ME)超过280μm的患者。借助一种新型脉络膜上腔微针(Pricon,Iscon Surgicals,焦特布尔,拉贾斯坦邦,印度)对研究眼进行单次LD-SCTA(0.5ml)注射。在LD-SCTA注射后4周和12周记录研究参数。

结果

11例患者中有10例中心黄斑厚度(CMT)显著降低。10例对治疗有反应的患者基线时平均CMT测量值为513.6±191.73μm,在4周和12周时分别显著降至265.1±34.72μm(P<0.003)和260.6±34.72μm(P<0.002)。基线时平均最佳矫正视力(BCVA)为0.84±0.41 logMAR单位,在4周和12周时分别提高至0.52±0.33(P<0.001)和0.25±0.22(P<0.000)。基线时记录的平均眼压为16.36±2.97 mmHg,4周时为19.45±4.80 mmHg(P = 0.06),12周时为17.27±2.53 mmHg(P = 0.35)。1例对LD-SCTA无反应的眼为复发性Vogt-小柳-原田病。

结论

单次LD-SCTA注射在降低ME患者的CMT、改善BCVA以及控制非感染性后葡萄膜炎炎症方面有效。与其他类固醇给药途径相比,LD-SCTA可作为非感染性葡萄膜炎的一线治疗方法,具有良好的疗效和安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d91a/10903718/ca1008547edd/MEAJO-30-6-g001.jpg

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