Morescalchi Francesco, Gandolfo Federico, Romano Vito, Baldi Andrea, Semeraro Francesco
Eye Clinic, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121, Brescia, Italy.
ASST Spedali Civili di Brescia: Azienda Socio Sanitaria Territoriale Degli Spedali Civili di Brescia, 25123, Brescia, Italy.
Int J Retina Vitreous. 2025 Jan 9;11(1):2. doi: 10.1186/s40942-024-00623-8.
To analyse the effect of suprachoroidal injection (SChI) of triamcinolone acetonide (TA) on macular thickness (CRT), ectopic inner foveal layer thickness (EIFL-T) and best corrected visual acuity (BCVA) in pseudophakic patients undergoing vitrectomy for epiretinal membrane (iERM) compared to intravitreal injection of TA (IVTA).
Prospective matched comparison of patients undergoing vitrectomy for Govetto stage 3 and 4 iERM. 25 eyes receiving IVTA (G-1) were compared to 23 eyes receiving SChI-TA (G-2) during vitrectomy. Primary outcome was change in BCVA, CRT, EIFL-T before surgery and 1, 3 and 6 months after surgery. Secondary outcome was the incidence of cystoid macular edema (CME).
Six months after surgery, G2 had a greater mean reduction in CRT (-222 µm vs -131 µm) and EIFL-T (-200 µm vs -104 µm) than G1. BCVA improved more in G2 than in G1 (p = 0.02). Foveal depression reformed in 43% of cases in G-2 and 16% of cases in G-1. Incidence of postoperative CME was 16% in G-1 and 4.3% in G-2.
During vitrectomy for iERM, SChI-TA was more effective than IVTA in reducing CRT and EIFL-T and improving BCVA. SChI-TA was effective in preventing postoperative CME. SChI-TA treatment was safe and reproducible and did not affect postoperative IOP. Trial registration NP6289-June 18th, 2024 (retrospectively registered).
分析玻璃体切除治疗视网膜前膜（iERM）的假晶状体患者中，玻璃体内注射曲安奈德（IVTA）与脉络膜上腔注射曲安奈德（SChI）对黄斑厚度（CRT）、异位中心凹内层厚度（EIFL-T）和最佳矫正视力（BCVA）的影响。
对Govetto 3期和4期iERM患者进行玻璃体切除术的前瞻性配对比较。将25只接受IVTA的眼睛（G-1组）与23只在玻璃体切除术中接受SChI-TA的眼睛（G-2组）进行比较。主要结局是术前及术后1、3和6个月时BCVA、CRT、EIFL-T的变化。次要结局是黄斑囊样水肿（CME）的发生率。
术后6个月，G2组CRT（-222 µm对-131 µm）和EIFL-T（-200 µm对-104 µm）的平均降低幅度大于G1组。G2组BCVA的改善程度大于G1组（p = 0.02）。G-2组43%的病例中心凹凹陷恢复，G-1组为16%。G-1组术后CME发生率为16%，G-2组为4.3%。
在玻璃体切除治疗iERM时，SChI-TA在降低CRT和EIFL-T以及改善BCVA方面比IVTA更有效。SChI-TA可有效预防术后CME。SChI-TA治疗安全且可重复，不影响术后眼压。试验注册号NP6289 - 2024年6月18日（回顾性注册）。
