曲安奈德与雷珠单抗治疗黄斑水肿的疗效对比

目的 对比曲安奈德与雷珠单抗治疗不同类型黄斑水肿的疗效.方法 选择我院收治黄斑水肿患者80人80眼,其中包含糖尿病继发黄斑水肿患者40例40眼,视网膜静脉阻塞黄斑水肿患者40例40眼,根据病理原因将所有患者平均分为Ⅰ、Ⅱ、Ⅲ、Ⅳ组,每组20人,其中Ⅰ、Ⅱ组为糖尿病继发黄斑水肿患者,Ⅲ、Ⅳ组为视网膜静脉阻塞黄斑水肿患者....     

曲安奈德与雷珠单抗治疗继发性黄斑水肿的比较

目的 比较后部眼球筋膜下注射曲安奈德与玻璃体内注射雷珠单抗对视网膜中央静脉阻塞继发黄斑水肿的疗效.方法 回顾性分析郑州市第七人民医院2016年6月至2019年6月60例(60眼)视网膜中央静脉阻塞继发黄斑水肿的资料.所有患者分为雷珠单抗组和曲安奈德组,每组30例(30眼).分别进行雷珠单抗玻璃体内注射及曲安奈德后部眼球...     

雷珠单抗联合曲安奈德治疗糖尿病性肾病性黄斑水肿的效果

目的:探讨糖尿病性肾病性黄斑水肿行玻璃体内注射雷珠单抗联合后部眼球筋膜下注射曲安奈德的治疗效果。方法:回顾性分析郑州市第七人民医院2016年6月至2020年6月糖尿病性肾病性黄斑水肿60例(60眼)的临床资料。所有病例分为雷珠单抗组及雷珠单抗联合曲安奈德组,各30例(30眼)。分别行0.05 ml雷珠单抗玻璃体内注射及...     

曲安奈德与雷珠单抗治疗视网膜静脉阻塞继发黄斑水肿比较

目的： 比较曲安奈德(Triamcinolone Acetonide,TA)与雷珠单抗(Lucentis,LU)治疗视网膜静脉阻塞性黄斑水肿的临床疗效。

方法：回顾性分析40例最佳矫正视力(BCVA,小数视力)≤0.6,黄斑中心凹厚度(CMT)≥250μm的视网膜静脉阻塞性黄斑水肿患者,分别进行玻璃体腔注射TA(22例,4mg,0.1mL)或LU(18例,0.5mg,0.05mL)治疗。比较两种药物治疗前和治疗后1, 2wk; 1, 2, 3,6mo两组CMT与BCVA的改变情况

结果：两组在治疗后视力明显提高,术后各时间点均较术前具有显著改变(P<0.05), TA组治疗后1mo视力最好(BCVA,logMAR=0.30±0.20),LU组治疗后2mo视力最好(BCVA,logMAR=0.21±0.10),两组在治疗后黄斑水肿明显减轻,CMT明显降低,术后各时间点均具有统计学意义(P<0.05),两组治疗后2mo时黄斑水肿程度最低(TA组CMT=274.45±141.81μm,LU组CMT=225.83±22.86μm)。BCVA(小数视力)与CMT呈负相关。各项指标两组间均无统计学差异。

结论： 玻璃体腔注射TA及LU治疗视网膜静脉阻塞性黄斑水肿均可减轻黄斑水肿和改善视力,两者治疗效果无显著差异。     

玻璃体内注射雷珠单抗联合曲安奈德治疗Ⅱ型视盘血管炎继发黄斑水肿

目的 评价玻璃体内注射雷珠单抗(ranibizumab)联合曲安奈德(triamcinolone acetonide,TA)治疗Ⅱ型视盘血管炎继发黄斑水肿的临床疗效和安全性.方法 选取2013年1月至2015年12月Ⅱ型视盘血管炎继发黄斑水肿患者19例(19眼),所有患眼均行雷珠单抗玻璃体内注射,2周后行TA玻璃体内注射.术后随访6个月,观察视力、眼压、眼底表现、三维光学相干断层扫描、眼底荧光血管造影及相关并发症.随访期间若黄斑水肿复发则再次行雷珠单抗联合TA治疗,直至黄斑水肿消退.结果 治疗前患眼视力为0.16±0.09,黄斑中心凹视网膜厚度为(694.88 ±79.06) μm.治疗后1个月、3个月、6个月分别与治疗前相比,视力显著提高,黄斑中心凹视网膜厚度显著降低,差异均有统计学意义(均为P ＜0.05);治疗后3个月、6个月分别与治疗后1个月相比,视力及黄斑中心凹视网膜厚度无显著变化,差异均无统计学意义(均为P ＞0.05).除1眼在首次玻璃体内注射雷珠单抗后出现一过性眼压升高外,其余患眼随访期间眼压均在正常范围.治疗后1个月眼底荧光血管造影检查示视网膜出血、渗出明显吸收,视盘及黄斑部荧光素渗漏明显减轻.患眼平均注药次数为2.11次.随访期间均未观察到与玻璃体内注射及药物相关的并发症.结论雷珠单抗联合TA治疗Ⅱ型视盘血管炎继发性黄斑水肿具有良好的疗效及安全性,可以明显缩短治疗周期、减少药物注射次数,手术创伤小、并发症少.     

雷珠单抗联合曲安奈德在息肉状脉络膜血管病变患者治疗中的临床疗效分析

目的 评估雷珠单抗联合曲安奈德(TA)玻璃体腔注射在息肉状脉络膜血管病变(PCV)患者治疗中的临床效果。方法 前瞻性随机对照研究。选取2019年8月至2020年12月在安徽省第二人民医院就诊的PCV患者30例(30只眼),分为雷珠单抗+TA联合注射组15例(15只眼),雷珠单抗单药注射组15例(15只眼),联合组在每次注射雷珠单抗注射液的同时在玻璃体腔注射TA混悬液0.5 ml,单药组每次仅雷珠单抗玻璃体腔注射,观察两组患者在1年时间内的最佳矫正视力(BCVA)、中心视网膜厚度(CRT)和注射频次的变化。两组患者遵从(Treat&Extend,T&E)治疗原则。结果 在1年的随访时间内,联合组和单药组在BCVA提升和CRT降低方面的治疗效果对比无差异(P> 0.05),但在注射频次方面,联合组1年平均注射4.27针,单药组平均注射为5.00针,两组间对比有统计学差异(P <0.05)。结论 雷珠单抗联合TA玻璃体腔注射在PCV患者的治疗中,较雷珠单抗单药注射,虽不能改善患者在BCVA提升和CRT降低的获益,但可减少注射频次,从而减轻患者的就医负担和降低医疗成...     

曲安奈德联合阿柏西普治疗雷珠单抗应答不良的湿性年龄相关性黄斑变性

目的:比较阿柏西普玻璃体内注射联合曲安奈德后部眼球筋膜下注射治疗抗血管内皮生长因子(VEGF)药物雷珠单抗应答不良的湿性年龄相关性黄斑变性(ARMD)的效果及安全性。方法:回顾性队列研究。2018-06/2020-05对抗VEGF药物雷珠单抗治疗应答不良的难治性ARMD 60例60眼,随机分为阿柏西普对照组及曲安奈德联合阿柏西普观察组,每组30例30眼。两组患者每月1次分别行单纯阿柏西普玻璃体内注射或阿柏西普玻璃内注射联合曲安奈德后部眼球筋膜下注射,连续注射3次。分别于注射前和注射第3次后1、3、6mo进行复查视力(BCVA)、黄斑中心凹厚度(CMT)及眼压的改变。结果:两组患者在治疗后1、3、6mo的BCVA及CMT均明显好转(P<0.05)。观察组治疗后1mo平均眼压较前升高,但仍在正常范围,两组眼压比较有差异(17.50±4.60 vs 18.30±3.73mmHg,P<0.05)。结论:曲安奈德后部眼球筋膜下注射联合阿柏西普玻璃体内注射治疗湿性ARMD,有效地减轻黄斑区水肿并改善视力,更加安全可靠。     

后部眼球筋膜下注射曲安奈德联合雷珠单抗治疗弥漫性糖尿病性黄斑水肿的效果

目的:评估后部眼球筋膜下注射曲安奈德联合玻璃体内注射雷珠单抗治疗弥漫性糖尿病性黄斑水肿(DME)的效果及安全性。方法:回顾性分析2019年4月至2021年4月郑州市第七人民医院弥漫性DME 60例(60眼)的临床资料。所有患者根据治疗方式分为两组,各30例(30眼)。单纯行雷珠单抗玻璃体内注射者为对照组,曲安奈德注射液...     

曲安奈德与雷珠单抗辅助治疗弥漫性糖尿病性黄斑水肿的疗效比较

目的：对曲安奈德与雷珠单抗用于弥漫性糖尿病性黄斑水肿(DME)的临床疗效观察比较。

方法：将2016-02/2017-05我院收治的84例弥漫性DME患者作为研究对象,遵循1：1的配对原则将患者分为Ⅰ、Ⅱ两组,两组均采用激光光凝手术治疗,Ⅰ组光凝术前予以曲安奈德辅助治疗,Ⅱ组术前予以雷珠单抗辅助治疗,对两组临床疗效作回顾性分析与比较。

结果：Ⅱ组患者治疗后3mo临床总有效率为93%,高于Ⅰ组总有效率77%(χ²=4.981,P=0.025); 与治疗前相比,两组治疗后各时间段BCVA、CMT均得到明显改善(P<0.05); Ⅱ组治疗后1、3mo BCVA指标改善优于Ⅰ组(P<0.05); Ⅱ组治疗后1、3、6mo CMT改善更优于Ⅰ组,差异有统计学意义(P<0.05); Ⅰ组与Ⅱ组不良反应发生率分别为17%、13%,差异无统计学意义(χ²=0.243,P=0.621)。两组均未发生视网膜脱落、眼内炎、白内障等严重的不良反应。

结论：与曲安奈德相比较,雷珠单抗用于弥漫性DME的疗效更佳,具有较高的临床应用价值。     

雷珠单抗联合曲安奈德治疗湿性年龄相关性黄斑变性的疗效及对白介素的影响

目的：观察雷珠单抗联合曲安奈德治疗湿性年龄相关性黄斑变性（AMD）的临床疗效,并探讨该疗 法对白介素（IL）-1β、IL-2、IL-6、IL-8水平的影响。方法：前瞻性研究。选取2017年11月至2018 年10月内蒙古包钢医院收治的86例（102眼）湿性AMD患者,采用随机数表法分为雷珠单抗组（43 例,50眼）和联合组（43例,52眼）,雷珠单抗组患者实施玻璃体腔注射雷珠单抗治疗,联合组在雷 珠单抗组基础上加用曲安奈德治疗。比较2组治疗前,治疗后2周、1个月及3个月眼压值;比较2组 治疗前,治疗后1、3、6个月黄斑中心凹厚度（CMT）及视力变化;比较2组治疗前、治疗后1个月血 清IL-1β、IL-2、IL-6、IL-8水平;对治疗期间2组并发症发生情况。采用t检验、重复测量方差分析 及χ2 检验对数据进行分析。结果：2组患者眼压值比较,差异无统计学意义（F组间=1.275,P=0.496; F时间=1.810,P=0.211;F交互=1.772,P=0.335）;治疗前2 组CMT、视力比较,差异无统计学意义 （t=0.042,P=0.967;t=0.720,P=0.473）;治疗后1、3、6个月,联合组CMT均低于雷珠单抗组（t=2.086, P=0.039;t=3.398,P=0.001;t=2.987,P=0.004）,视力均高于雷珠单抗组（t=3.265,P=0.001;t=2.217, P=0.029;t=2.519,P=0.013）;随着治疗时间的延长,2组CMT均呈降低趋势（t治疗前vs.治疗后1个月=6.210、 4.218,P<0.001;t治疗后1个月vs.治疗后3个月=16.772、15.865,P<0.001;t治疗后3个月vs.治疗后6个月=4.472、4.848, P<0.001）,视力呈升高趋势（t治疗前vs.治疗后1个月=4.527、8.395,P<0.001;t治疗后1个月vs.治疗后3个月=5.369、5.349, P<0.001;t治疗后3个月vs.治疗后6个月=3.335、3.730,P<0.001）;与治疗前相比,治疗后1个月2组血清IL-1β、 IL-6、IL-8水平均降低（t联合组=10.544、32.169、33.156,均P<0.001;t雷珠单抗组=8.996、25.687、30.754, 均P<0.001）,且联合组低于雷珠单抗组（t=2.894,P=0.005;t=5.997,P<0.001;t=3.934,P<0.001）;与 治疗前相比治疗后3个月2组血清IL-2水平均升高（t=20.067、9.091,均P<0.001）,且联合组高于雷 珠单抗组（t=7.705,P<0.001）;2组出血、眼内异物感、一过性眼压升高发生率及并发症总发生率比 较,差异均无统计学意义（校正χ2 =0.001,P=0.972;校正χ2 =0.221,P=0.638;Fisher精确检验P=0.116; 校正χ2 =0.004,P=0.951）。结论：玻璃体腔注射雷珠单抗联合曲安奈德可有效改善湿性AMD视觉功能, 降低CMT及血清IL-1β、IL-6、IL-8水平,增加血清IL-2水平,缓解炎症反应程度。     

Vitrectomy Combined with Intravitreal Triamcinolone Acetonide Injection and Macular Laser Photocoagulation for Nontractional Diabetic Macular Edema

Purpose

To evaluate the efficacy of vitrectomy combined with intravitreal injection of triamcinolone acetonide (IVTA) and macular laser photocoagulation for the treatment of nontractional diabetic macular edema (DME) refractory to anti-vascular endothelial growth factor (VEGF) therapy.

Methods

Twenty-eight eyes from 28 subjects who were diagnosed with nontractional DME refractory to three or more sequential anti-VEGF injections underwent sequential vitrectomy, IVTA, and macular laser photocoagulation. Changes in best-corrected visual acuity (BCVA) and central subfield thickness (CST) during the six months following vitrectomy were evaluated. Additionally, the CST and BCVA outcomes were compared with those of 26 eyes treated with the same triple therapy for nontractional DME refractory to conventional treatment, such as IVTA or macular laser photocoagulation, or both.

Results

The mean logarithm of the minimum angle of resolution BCVAs before and one, three, and six months after vitrectomy were 0.44 ± 0.15, 0.36 ± 0.18, 0.31 ± 0.14, and 0.34 ± 0.22, respectively. The mean CSTs were 433.3 ± 77.9, 329.9 ± 59.4, 307.2 ± 60.2, and 310.1 ± 80.1 microns, respectively. The values of both BCVA and CST at one, three, and six months were significantly improved from baseline (p < 0.05). The extent of CST reduction during the first month after triple therapy was greater in eyes refractory to conventional treatment than in eyes refractory to anti-VEGF (p = 0.012).

Conclusions

Vitrectomy combined with IVTA and macular laser photocoagulation had a beneficial effect on both anatomical and functional outcomes in eyes with nontractional DME refractory to anti-VEGF therapy.     

曲安奈德玻璃体腔注射治疗视网膜黄斑分支静脉阻塞继发黄斑水肿

目的 评价玻璃体腔注射曲安奈德(intravitreal triamcinolone acetonide,IVTA)治疗黄斑分支静脉阻塞(macular branch retinal vein occlusion,MBRVO)继发黄斑水肿的疗效及安全性.方法 经荧光素眼底血管造影(fluorescein fundus angiography,FFA) 、光学相干断层扫描(optical coherence tomography,OCT)等检查确诊为MBRVO继发黄斑水肿并进行IVTA治疗的患者共51例(51眼),观察术前及术后最佳矫正视力、FFA渗漏改变、OCT显示的黄斑水肿变化及并发症.结果 术后所有患者视力得到稳定或提高,相应的平均黄斑中心视网膜厚度降低,差异均有显著统计学意义(P＜0.01).治疗后6个月有44眼(86.3﹪)荧光渗漏消失或减轻,7眼(13.3﹪)不变或有所加重.8眼(16.4﹪)术后一过性眼压升高;3眼(5.9﹪)在术后6个月白内障明显进展;无感染性眼内炎及其他并发症发生.结论 IVTA是治疗MBRVO继发黄斑水肿的一种安全且有效的方法.     

The Variable Efficacy of Intravitreal Bevacizumab and Triamcinolone Acetonide for Cystoid Macular Edema Due to Radiation Retinopathy

Abstract

Background: Both intravitreal bevacizumab and triamcinolone have been shown to be effective in treating macular edema secondary to VEGF-mediated disease. The purpose of this study is to describe the variable effects of intravitreal bevacizumab (IVB) and triamcinolone acetonide (IVTA) in the treatment of macular edema secondary to radiation retinopathy. Methods: Retrospective, nonrandomized, interventional case series. Charts of five patients with macular edema due to radiation retinopathy who received IVB with subsequent IVTA were reviewed. Clinical examination, Snellen visual acuity (VA), and central macular thickness (CMT) on optical coherence tomography (OCT) were examined. Main outcome measures included VA and CMT. Results: Of the five patients reviewed, patient 1 demonstrated complete resolution of macular edema both clinically and by OCT with IVB after the first two injections with a decrease in CMT to 243 and 284?µm from a baseline CMT of 340?µm. However, response diminished following successive injections and the patient was switched to IVTA with a complete response. Mean CMT was 249?µm following four injections of IVTA and vision improved 3 lines. Patients 2 and 3 demonstrated a partial response to IVB with a mean CMT of 362 and 451?µm from 436 and 596?µm, respectively. They similarly had a partial response to IVTA with a mean CMT of 363 and 433?µm from 460 and 429?µm. There was no improvement in vision. Patient 2 was then switched to a combination of IVB and IVTA with complete resolution of macular edema with a CMT of 299 and 289?µm following two treatments. Patients 4 and 5 failed to respond to IVB with a mean increase in CMT of 64.5 and 6?µm. Both responded well to IVTA with complete resolution of macular edema. Mean decrease in CMT was 146 and 183?µm with a mean CMT of 254 and 281?µm. Final vision was stable in patient 4 and improved 3 lines from 20/100 to 20/50 in patient 5. Conclusion: IVB and IVTA have variable effects on the reduction of macular edema due to radiation retinopathy. IVB appears to have an initial effect in reducing macular edema in some patients but after multiple injections there can be resistance to its effects. IVTA was effective in three of five patients with complete resolution of macular edema. The combination of IVB and IVTA completely resolved macular edema in one patient resistant to IVB or IVTA alone. The reason for this may be due to their different therapeutic mechanisms of action and consideration should therefore be given to their use in combination.     

Intravitreal Injection of Dexamethasone Implant and Ranibizumab in Cystoid Macular Edema in the Course of Irvine-Gass Syndrome

Purpose

To evaluate the efficacy of 2 dexamethasone intravitreal implants and 1 ranibizumab intravitreal injection after a bilateral postoperative complication of cataract surgery as pseudophakic cystoid macular edema.

Patients and Methods

A 70-year-old male patient with systemic hypertension developed a progressive cystoid macular edema (CME) in both eyes starting between 10 and 20 days after cataract surgery. Two intravitreal dexamethasone implants and 1 ranibizumab injection were administered; first in the right eye (RE) and then in the left eye (LE). The patient was checked for 1 whole week and then once a month for 5 months after the injections.

Results

One month after the first dexamethasone implant in his RE, the spectral domain optical coherence tomography (SD-OCT) showed a progressive reduction of the foveal thickness until a complete resolution of the CME occurred, which was associated with an improvement of visual acuity. After 3 months, the SD-OCT showed a relapse of the CME, which was then treated with 1 injection of ranibizumab. One month after this injection, there was a complete resolution of the CME. A new CME in his RE was diagnosed 2 months after the last ranibizumab injection; it was treated with a new dexamethasone implant. A complete resolution of the CME was obtained; a normal foveal profile was still present 5 months after the last injection, and the best-corrected visual acuity was 20/20. His LE developed a CME 40 days after surgery. One intravitreal injection of ranibizumab was first administered in his LE, with a complete resolution of the CME at SD-OCT 2 weeks later. As observed in his RE, 40 days after the ranibizumab injection, there was a relapse of the CME that was treated with 1 intravitreal injection of dexamethasone implant. Five months later, the patient showed a worsening of the CME, but it was completely resolved with a second dexamethasone injection. After 3 months, the foveal thickness was back to normal with a BCVA of 20/20.

Conclusion

Treatment with dexamethasone implants (Ozurdex^®) and ranibizumab injections (Lucentis^®) induced a progressive reduction of our patient''s CME after cataract surgery (Irvine-Gass syndrome) until a complete normal foveal thickness was restored and his visual function was improved despite the order of injections.Key words: Irvine-Gass syndrome, Cystoid macular edema, Intravitreal injection, Dexamethasone, Ranibizumab, Cataract, Surgery, Complication     

Safety and Efficacy of Intravitreal Triamcinolone Acetonide for Uveitic Macular Edema

Background: To evaluate the safety and efficacy of intravitreal triamcinolone acetonide (TA) for treating macular edema secondary to non-infectious uveitis. Methods: Retrospective review of sixteen patients (20 eyes) with chronic cystoid macular edema (CME) as a consequence of controlled intermediate uveitis, posterior uveitis, or panuveitis who received at least one intravitreal injection of TA. Main outcome measures were visual acuity (VA), intraocular pressure (IOP), formation or progression of an existing cataract, and CME resolution during the follow-up period. Results: At last follow-up, VA showed improvement (compared to baseline) in 11 eyes (55%), deterioration in three eyes (15%), remained completely unchanged in one eye (5%), and showed improvement initially but returned to baseline levels in five eyes (25%). At last follow-up, CME had relapsed or was still present in 10 of the eyes (50%). The remaining eyes showed complete resolution of the CME, without evidence of recurrence during the follow-up time. Mean VA at last follow-up showed statistically significant improvement (p = 0.02) in nonvitrectomized eyes (mean baseline VA: 1.14 ± 0.58; mean final VA: 0.96 ± 0.66) compared to the almost unaltered mean visual acuity for vitrectomized eyes (mean baseline VA: 0.76 ± 0.41; mean final VA: 0.71 ± 0.48)(p = 0.40, paired samples t-test). Elevation of IOP was transient in all cases and responded well to topical medications, except for one patient who required placement of an Ahmed valve. Preexisting cataract progressed in three of the 15 phakic eyes (20%). One patient developed a retinal detachment and required additional surgery to reattach it. Patients were followed for a mean of 34 weeks (median: 32 weeks; range: 19–56 weeks). Conclusions: Intravitreal TA may play a role in the treatment of uveitis-related CME. Further controlled studies are necessary to test this hypothesis.     

Comparison of Subtenon Triamcinolone Acetonide Injection with Topical Nepafenac for the Treatment of Pseudophakic Cystoid Macular Edema

Purpose: To compare the efficacy and safety of subtenon triamcinolone acetonide (TA) injection with topical nepafenac 0.1% for the treatment of pseudophakic cystoid macular edema (CME).

Methods: In this prospective study, the TA group comprised 24 eyes and the nepafenac group 24 eyes. Best-corrected visual acuity (BCVA), central retinal thickness (CRT), intraocular pressure measurements, and slit-lamp fundoscopy were performed in all subjects at baseline, 1, 2, 3, and 6 months.

Results: Changes in BCVA and CRT over four follow-up visits were statistically significant (p<0.001). The mean CRT decreased from 513.3 to 318.9 μm in the TA group and from 483.7 to 278.0 μm in the nepafenac group. This reduction was statistically significant (p<0.001 for both groups).

Conclusions: Our visual and OCT results suggest that both treatment modalities are effective with few side-effects. However, nepafenac is more efficacious than subtenon TA in terms of visual gain and its correlation with the reduction in CRT.     

Intravitreal Triamcinolone Acetonide for Macular Edema in HLA-B27 Negative Ankylosing Spondylitis

We report a case of a human leukocyte antigen B27 (HLA-B27)-negative patient with cystoid macular edema (CME) and ankylosing spondylitis (AS) after treatment with triamcinolone acetonide. The patient complained of deterioration of visual acuity of the right eye during the last 10 days. At presentation visual acuity of the right eye was 0.2, and the ophthalmic examination did not reveal any sign of active uveitis. Fluorescein angiography (FA) and ocular coherent tomography (OCT) showed CME. The left eye was normal with a visual acuity of 0.9. Eight weeks after intravitreal injection of triamcinolone acetonide, visual acuity improved to 0.8 and OCT revealed regression of macular edema. Six months later no recurrence was observed. Our case report indicates for the first time that CME may occur in AS independently of the presence of HLA-B27 and intraocular inflammation. Intravitreal use of triamcinolone acetonide can reduce macular edema and restore visual acuity.     

Twenty-Four Months Follow-Up of Intravitreal Bevacizumab Injection Versus Intravitreal Triamcinolone Acetonide Injection for the Management of Persistent Non-Infectious Uveitic Cystoid Macular Edema

Purpose: To report the efficacy of intravitreal bevacizumab (IVB) injection versus intravitreal triamcinolone acetonide (IVT) for persistent non-infectious uveitic cystoid macular edema (CME).

Methods: Interventional retrospective comparative case series evaluated 37 consecutive patients (44 eyes) with completely controlled uveitis and recalcitrant CME. Patients received repeated injections of 1.25 mg of IVB or 4 mg of IVT.

Results: Best-corrected visual acuity (BCVA) at baseline and 24 months was logMAR 1 and 0.8 respectively, in the IVB group (p = 0.002) and; logMAR of 1.1 and 0.6, in the IVT group (p = 0.001). Central macular thickness at baseline and 24 months was 399.2 µm and 333.7 µm (p < 0.0009), respectively, for the IVB group and; 464.4 µm and 316.5 µm in the IVT group (p = 0.044). Postoperatively, IOP increased in the IVT group.

Conclusions: Repeated injections with IVT improve BCVA as effectively as repeated injections with IVB in the long-term management of persistent uveitic CME.     

曲安奈德玻璃体腔内注射治疗黄斑水肿的疗效观察

目的探讨曲安奈德(Triamcinolone acetonide,TA)玻璃体腔内注射治疗黄斑水肿的临床疗效.方法回顾分析21例黄斑水肿患者玻璃体腔内注射TA前后的视力、荧光素眼底血管造影(fundus fluorescence angiography,FFA)、光相干断层扫描(optical coherence tomography,OCT)的检查资料及并发症.结果治疗前平均视力0.10±0.04;治疗后平均视力0.26±0.18(P＜0.01).视力提高者18例,不变者3例.治疗3个月后FFA检查显示黄斑区毛细血管渗漏明显减轻者14例,渗漏轻度减轻者4例,无改变者3例,黄斑水肿消减率达85.71%,OCT检查显示黄斑区视网膜厚度降低150μm以上者18例,无改变者3例.治疗后并发症眼压升高、玻璃体积血、视网膜脱离等.行对症治疗后症状消除.视网膜脱离患者手术后视功能未改善.结论选择合适的适应证,玻璃体腔内注射TA对治疗黄斑水肿有明显的疗效.     

Interferon Alpha for Refractory Pseudophakic Cystoid Macular Edema (Irvine-Gass Syndrome)

ABSTRACT

Purpose: To assess the efficacy and safety of systemic interferon alpha-2a (IFN) for refractory pseudophakic cystoid macular edema (PCME).

Methods: Retrospective observational study. The primary outcome was the decrease of central retinal thickness (CRT). Secondary endpoints were the improvement of best-corrected visual acuity (BCVA) and the assessment of IFN-related side effects.

Results: Twenty-four eyes of 20 patients were included. The median CRT was 513 µm (range 220–980 µm) at baseline and decreased to 190 µm (range 140–520 µm) at the last follow-up visit (p < 0.001). Reduction of CRT greater than 100 µm was observed in 22 eyes (92%). The median BCVA (logMAR) increased statistically significant from 0.5 (range 0.2–1.5) at baseline to 0.3 (0–0.8) at the last follow-up (p < 0.001). The BCVA improved in 18 eyes (75%) and remained stable in five eyes (21%). No severe treatment-related side effects occurred.

Conclusion: IFN is a very effective agent for treatment of refractory PCME.