Branch retinal vein occlusion treated by intravitreal triamcinolone

CLINICAL CASES: Five eyes with branch retinal vein occlusion (BRVO) were treated with intravitreal injection of 4 mg of triamcinolone. Four cases showed good visual acuity and macular thickness evolution after one dose. The remaining one case suffered a relapse three months later. Therefore a second injection was performed in that case. DISCUSSION: Several treatments have been suggested to manage macular edema in BRVO. Intravitreal triamcinolone may be a therapeutic option to increase visual acuity and decrease macular thickness in patients with macular edema secondary to BRVO.     

玻璃体腔注射曲安奈德减轻视网膜静脉阻塞继发的黄斑水肿

目的:评估玻璃体腔内注射曲安奈德(triamcinolone acetonide,TA)治疗视网膜静脉阻塞(retinal vein occlusion,RVO)引起的黄斑水肿的长期安全性与有效性。方法:患者17例17眼出现视网膜静脉阻塞引起的黄斑水肿,接受玻璃体腔内注射2mgTA,随访1a,监测患者视力、黄斑厚度。结果:随访发现,15眼(88%)视力得到明显改善,从术前0.114±0.068增加到术后的0.184±0.094,差异有统计学意义(P<0.05),而中央黄斑区的厚度从术前的514.0±67.4μm减少到术后的442.0±61.5μm,差异有统计学意义(P<0.05)。术后6例患者出现短期眼压升高,并无并发性白内障,玻璃体出血,视网膜脱离以及眼内炎的发生。结论:玻璃体腔内注射TA能长期有效减缓RVO引起的黄斑水肿。     

Macular oedema in central retinal vein occlusion treated with intravitreal triamcinolone

PURPOSE: To investigate the efficacy of intravitreal triamcinolone as treatment for macular oedema in central retinal vein occlusion (CRVO). METHODS: We conducted a retrospective comparative case series of nine patients with macular oedema associated with CRVO (six non-ischaemic and three ischaemic) treated with an intravitreal injection of 4 mg triamcinolone acetonide, compared with 10 control (observation) patients (six non-ischaemic and four ischaemic). Examination included visual acuity (VA) tests and complete ophthalmic examinations at baseline, 1, 2 and 6 months postoperatively. RESULTS: The mean baseline VA was 20/161 for CRVO treatment group patients and 20/75 for observation group patients (p = 0.15). No significant difference in VA between CRVO treatment group patients (20/99) and controls (20/282) was observed at the final 6-month visit (p = 0.33). Subgroup analysis of the non-ischaemic CRVO treatment patients compared with the non-ischaemic controls also showed no significant difference at the 6-month visit (20/59 and 20/100, respectively; p = 0.20). At 6 months, five of the six non-ischaemic treated patients had VA >or= 20/100, compared with five of the six non-ischaemic control patients. All patients tolerated the procedure well, but there was a significant increase in intraocular pressure by the 2-month visit (p = 0.015). CONCLUSIONS: Intravitreal injection of triamcinolone may not be effective for treatment of macular oedema in all CRVO patients or all non-ischaemic CRVO patients. A trend towards VA improvement was noted but was not statistically significant. Although our treatment was not hindered by severe complications, there was a significant increase in IOP in the 2 months following treatment.     

曲安奈德玻璃体腔注射治疗视网膜分支静脉阻塞继发黄斑水肿

目的:观察玻璃体腔注射曲安奈德(tviamcinolone ace-tonide,TA)治疗视网膜分支静脉阻塞(branch retinal vein occusion,BRVO)继发黄斑水肿的疗效。方法:经眼底检查、荧光眼底血管造影(FFA)、光学相干断层扫描(OCT)检查确诊的BRVO继发黄斑水肿22例(22眼)行玻璃体腔曲安奈德注射,治疗后随访(4.2±0.4)mo,对比治疗前及治疗后1,3mo视力、眼压、眼底、FFA表现、OCT所显示黄斑水肿高度以及黄斑中心凹阈值。结果:治疗的22眼中19眼(82%)视力明显提高,3眼(14%)视力不变,治疗前平均视力0.10±0.06,治疗后1,3mo平均视力分别为0.25±0.12、0.28±0.13,黄斑中心凹厚度(OCT)治疗前平均厚度(519.0±137.5)μm,治疗后1,3mo平均厚度分别为(256.4±68.3)μm、(239.4±52.2)μm,黄斑中心凹阈值(dB):治疗前(18.8±4.2)dB,治疗后1,3mo分别为(24.0±6.0)dB、(24.6±5.2)dB,治疗前后比较差异有统计学意义(P<0.01)。22眼中有6眼(27%)治疗后暂时性眼压升高,经局部抗青光眼药物治疗后恢复正常。5例(23%)患者2次注药。结论:玻璃体腔注射TA在短期内可有效改善BRVO继发黄斑水肿,但也要注意对原发病治疗。     

The efficacy of intravitreal triamcinolone acetonide on macular edema in branch retinal vein occlusion

PURPOSE: To evaluate the effectiveness of intravitreal triamcinolone acetonide as primary treatment of macular edema in branch retinal vein occlusion. METHODS: Fifteen eyes of 15 patients with macular edema due to branch retinal vein occlusion (Group 1) who received 8 mg/0.2 ml of intravitreal triamcinolone injection as primary treatment were retrospectively evaluated. The control group (Group 2) consisted of 19 eyes of 19 patients who had received laser treatment for macular edema. The main outcome measures included best-corrected visual acuity, intraocular pressure, and macular edema map values of Heidelberg Retinal Tomograph II. RESULTS: In Group 1, mean visual acuity improved significantly from a mean logMAR (logarithm of minimal angle of resolution) value of 0.98+/-0.19 at baseline to a maximum of 0.24+/-0.24 during a mean follow-up time of 6.3 months. In the control group, the mean baseline log-MAR visual acuity before laser treatment was 1.02+/-0.22, and it was 0.50+/-0.28 at 6-month examinations. Mean improvement in visual acuity at 1-, 3-, and 6-month examinations was significantly higher in Group 1 when compared with the control group (for each, p<0.001). The mean edema map value of Group 1 significantly decreased by 40% at 6-month examinations when compared with preinjection value (p<0.001). In Group 1, mean increase in intraocular pressure elevation was 19.8% at the 1-month, 26.9% at 3-month, and 5.7% at 6-month visits, but intraocular pressures were under control with topical antiglaucomatous medications. CONCLUSIONS: Intravitreal triamcinolone acetonide injection may be a new and promising approach as initial therapy for macular edema due to branch retinal vein occlusion.     

Early versus late intravitreal triamcinolone acetonide for macular edema associated with branch retinal vein occlusion

PURPOSE: To compare the effect of early versus late intravitreal injection of triamcinolone in patients with macular edema due to branch retinal vein occlusion (BRVO). METHODS: Twenty eyes of 20 patients with macular edema from BRVO, including 10 with duration after onset of or 3 months, improvements in visual acuity and foveal thickness, though apparent at 1 month, were not maintained at 3 and 6 months post-triamcinolone. CONCLUSIONS: Intravitreal triamcinolone is more effective in patients with BRVO who are treated earlier.     

Effects of intravitreal triamcinolone acetonide on retinal gene expression in a rat model of central retinal vein occlusion

Purpose  

The aim of this study was to investigate the effects of intravitreal triamcinolone acetonide on the alterations in retinal gene expression in a rat model of central retinal vein occlusion (CRVO).     

曲安奈德玻璃体腔注射治疗视网膜静脉阻塞和糖尿病视网膜病变继发黄斑水肿分析

目的 观察玻璃体腔注射曲安奈德(TA)治疗视网膜静脉阻塞(RVO)继发黄斑水肿和糖尿病性黄斑水肿的疗效以及二者疗效比较.方法 对经间接检眼镜、荧光素眼底血管造影(FFA)以及光学相干断层扫描(OCT)检查确诊的RVO继发黄斑水肿患者91例91只眼,其中中央视网膜静脉阻塞(CR-VO)55只眼(缺血型13只眼,非缺血型42只眼),分支视网膜静脉阻塞(BRVO)36只眼(缺血型10只眼,非缺血26眼).糖尿病性黄斑水肿患者67例73只眼,非增殖性糖尿病视网膜病变(PPDR)17只眼,增殖性糖尿病视网膜病变(PDR)56只眼,行TA玻璃体腔注射,治疗后随访3月至1年,对比分析术前术后的视力、眼底、FFA表现,观察OCT显示黄斑水肿高度.结果 最终随访RVO组视力提高者48只眼(52.7%),视力不变者39只眼(42.9%),视力下降者4只眼(4.40%).OCT形态恢复正常者50只眼(54.9%),改善者27只眼(29.7%),无改善者14只眼(15.4%).DR组视力提高者25(34.2%)只眼,,视力不变者45只眼(61.6%),视力下降者3只眼(4.11%).OCT形态恢复正常者24只眼(32.9%),改善者22只眼(30.1%),无改善者27只眼(37.0%).两组有效率行统计学分析,有显著性差异.RVO组24只眼术后出现一过性眼压升高,一眼白内障,一眼眼内炎,8只眼2次注射.DR组14眼术后出现一过性眼压升高,2只眼白内障,9只眼2次注射.结论 玻璃体腔注射TA是一种安全有效的治疗视网膜静脉阻塞继发黄斑水肿和糖尿病性黄斑水肿的方法,治疗视网膜静脉阻塞继发黄斑水肿的疗效好于糖尿病性黄斑水肿.     

曲安奈德玻璃体腔注射治疗视网膜静脉阻塞继发黄斑水肿的疗效观察

目的观察玻璃体腔注射曲安奈德（TA）治疗视网膜静脉阻塞（RVO）继发黄斑水肿的疗效。方法对经间接检眼镜、荧光素眼底血管造影（FFA）以及光学相干断层扫描（OCT）检查确诊的RVO继发黄斑水肿患者39例39眼行TA玻璃体腔注射，治疗后随访1年，对比分析术前术后不同时期的视力、眼底、FFA表现，观察OCT显示黄斑水肿高度。结果中央视网膜静脉阻塞（CRVO）24眼（缺血型17眼，非缺血型7眼），分支视网膜静脉阻塞（BRVO）15眼（缺血型7眼，非缺血型8眼）。最终随访视力提高者28眼，比术前降低者5眼，不变者6眼。OCT形态恢复正常者15眼，改善者21眼，无改善者3眼。12眼术后出现一过性眼压升高。结论玻璃体腔注射TA是一种安全有效的治疗视网膜静脉阻塞继发黄斑水肿的方法。     

玻璃体腔注射曲安奈德治疗视网膜静脉阻塞黄斑水肿

目的：比较玻璃体腔注射曲安奈德和传统方法治疗视网膜静脉阻塞黄斑水肿的疗效。方法：共有21例因视网膜静脉阻塞导致黄斑水肿的患者纳入此项临床研究。接受治疗前所有的患者均进行了全面的眼科检查，并随机分为两组。实验组9例患者进行玻璃体腔注射4mg曲安奈德治疗；对照组12例患者接受传统方法治疗。结果：治疗前，对照组视力（logMAR）为1．20±0．38，而实验组为1．64±0．31。治疗后1mo，对照组的视力改善到0．98±0．54（logMAR），而曲安奈德治疗组改善到0．87±0．61（logMAR）。实验组和对照组之间视力改善有显著差异（P〈0．01）。结论：研究结果显示，尽管实验组和对照组的患者视力均有改善，但治疗视网膜静脉阻塞黄斑水肿，玻璃体腔注射曲安奈德比传统方法更有效。     

玻璃体腔注射曲安奈德治疗视网膜静脉阻塞黄斑水肿(英文)

目的:比较玻璃体腔注射曲安奈德和传统方法治疗视网膜静脉阻塞黄斑水肿的疗效。方法:共有21例因视网膜静脉阻塞导致黄斑水肿的患者纳入此项临床研究。接受治疗前所有的患者均进行了全面的眼科检查,并随机分为两组。实验组9例患者进行玻璃体腔注射4mg曲安奈德治疗;对照组12例患者接受传统方法治疗。结果:治疗前,对照组视力(logMAR)为1.20±0.38,而实验组为1.64±0.31。治疗后1mo,对照组的视力改善到0.98±0.54(logMAR),而曲安奈德治疗组改善到0.87±0.61(logMAR)。实验组和对照组之间视力改善有显著差异(P<0.01)。结论:研究结果显示,尽管实验组和对照组的患者视力均有改善,但治疗视网膜静脉阻塞黄斑水肿,玻璃体腔注射曲安奈德比传统方法更有效。     

Intravitreal triamcinolone acetonide for treatment of central retinal vein occlusion

PURPOSE: To evaluate the effect of intravitreal triamcinolone acetonide on visual acuity and intraocular pressure in patients with central retinal vein occlusion. METHODS: This prospective comparative non-randomized clinical interventional study included 32 patients (33 eyes) with central retinal vein occlusion. The study group (12 patients; 13 eyes) received an intravitreal injection of about 20 mg of triamcinolone acetonide. The control group (20 patients) did not receive any treatment. Mean follow-up was 10.1+/-8.6 months in the study group and 6.0+/-5.2 months in the control group. RESULTS: In the study group, mean visual acuity increased significantly (p=0.018) from 0.11+/-0.11 preoperatively to a best visual acuity during follow-up of 0.18+/-0.15. An improvement in visual acuity by at least 2 Snellen lines and 3 Snellen lines, respectively, was found for 8 (62%) eyes and 5 (38) eyes. Visual acuity measurements determined 1 month (p=0.038) and 3 months (p=0.046) after the injection were significantly higher than the baseline values. Increase in visual acuity was higher in the non-ischemic subgroup than in the ischemic subgroup. In the control group, baseline visual acuity and best visual acuity during the followup did not vary significantly (p=0.33). Visual acuity decreased significantly (p=0.007) towards the end of the follow-up. Comparing study group and control group, gain in visual acuity was significantly (p=0.01) higher in the study group. In the study group, intraocular pressure increased significantly (p=0.018) from 14.4+/-3.9 mmHg to a mean maximal value of 21.6+/-9.2 mmHg (range, 10-44 mmHg), and re-decreased (p=0.012) towards the end of follow-up to 15.3+/-5.1 mmHg (range, 10-21 mmHg). CONCLUSIONS: Intravitreal triamcinolone acetonide temporarily increases visual acuity in central retinal vein occlusion. It is accompanied by an increase in intraocular pressure.