Helm C J, Holland G N
UCLA Ocular Inflammatory Disease Center, Jules Stein Eye Institute 90024-7003, USA.
Am J Ophthalmol. 1995 Jul;120(1):55-64. doi: 10.1016/s0002-9394(14)73759-6.
Periocular injection of corticosteroids is a common treatment for vision loss in patients with intermediate uveitis. However, this treatment has the potential for serious side effects. We sought to determine the effects of such injections in a series of patients.
We reviewed charts of 20 consecutive patients (20 eyes, 43 injections) who had received posterior subtenon injections of triamcinolone acetonide for treatment of intermediate uveitis. We collected data on visual outcome and side effects.
Median follow-up was 23.5 months (range, one to 50 months). Snellen visual acuity improved by at least two lines in 12 (67%) of 18 patients who were examined after initial injection. Median time to improvement was three weeks. Patients with visual improvement had a median age of 29.0 years, compared with 41.5 years for nonresponders (P = .024). There was a weak association between response to treatment and a history of not smoking (P = .073) after correction for patient age. Increase of intraocular pressure (> 21 mm Hg) occurred in six patients (30%), with onset at a median of three weeks after initial injection; the median interval to peak increase (median, 32 mm Hg; range, 25 to 40 mm Hg) was 14 weeks after the injection.
A subtenon injection of triamcinolone acetonide appears to be an effective treatment for decreased vision associated with intermediate uveitis but may contribute to increase of intraocular pressure in some patients with this disorder.
眼周注射皮质类固醇是中间葡萄膜炎患者视力丧失的常见治疗方法。然而，这种治疗有产生严重副作用的可能性。我们试图确定此类注射在一系列患者中的效果。
我们回顾了连续20例患者（20只眼，43次注射）的病历，这些患者接受了曲安奈德后Tenon囊下注射以治疗中间葡萄膜炎。我们收集了视力结果和副作用的数据。
中位随访时间为23.5个月（范围1至50个月）。在初次注射后接受检查的18例患者中，12例（67%）的Snellen视力至少提高了两行。改善的中位时间为3周。视力改善的患者中位年龄为29.0岁，无反应者为41.5岁（P = 0.024）。在对患者年龄进行校正后，治疗反应与不吸烟史之间存在弱关联（P = 0.073）。6例患者（30%）出现眼压升高（>21 mmHg），初次注射后中位发病时间为3周；眼压升高至峰值（中位值32 mmHg；范围25至40 mmHg）的中位间隔时间为注射后14周。
Tenon囊下注射曲安奈德似乎是治疗与中间葡萄膜炎相关视力下降的有效方法，但可能会导致部分患有该疾病的患者眼压升高。
