Indocyanine-green-mediated photothrombosis (IMP) with intravitreal triamcinolone acetonide for macular edema secondary to group 2A idiopathic parafoveal telangiectasis without choroidal neovascularization: a pilot study
Indocyanine-green-mediated photothrombosis (IMP) with intravitreal triamcinolone acetonide for macular edema secondary to group 2A idiopathic parafoveal telangiectasis without choroidal neovascularization: a pilot study
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DOI：
10.1007/s00417-007-0633-2
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发表时间：
2007-11-01
影响因子：
2.7
通讯作者：
Garcia-Amaris, Rafael
中科院分区：
文献类型：
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作者：
Arevalo, J. Fernando;Sanchez, Juan G.;Garcia-Amaris, Rafael
本研究的目的是确定可行性，吲哚菁绿色（ICG）介导的光致血栓形成（IMP）联合玻璃体内曲安奈德（IVTA）治疗继发于特发性视网膜旁毛细血管扩张（IPFT）的黄斑水肿患者的安全性和临床效果（第2A组，无脉络膜新生血管（CNV））用IMP治疗后立即用4 mg剂量的IVTA治疗的6名患者的9只眼睛参与了该研究。患者平均随访23.3个月（范围12-36个月）。患者接受了一次或两次IMP联合IVTA治疗（“研究组”）。仅IVTA组包括14例继发于IPFT组2A的黄斑水肿患者的19只眼睛，接受了IVTA 4 mg，无IMP（“仅IVTA组”），用于比较。另外，从我们的病历中回顾性地选择了20例40只眼IPFT组2A继发性黄斑水肿患者作为对照组（“观察组”），其中5只眼（55.5%）的最佳矫正视力（BCVA）保持稳定。4只眼（44.4%）显示BCVA改善（>= 2 ETDRS行），无只眼出现视力恶化（>= 2 ETDRS行）。荧光素血管造影（FA）未观察到高荧光显著减少，但光学相干断层扫描（OCT）显示内部视网膜内低反射空间或囊性水肿的大小减少。2只眼（22.2%）出现眼内压升高。然而，通过局部抗青光眼药物进行了医学控制。术后并发白内障5眼（55.5%）。在研究期间，6/9只眼（66.6%）需要再次治疗。在仅IVTA组的末次随访（平均21.1个月，范围12-30个月）时，5只眼（25.3%）BCVA改善，11只眼（57.9%）保持在基线BCVA的两行内，3只眼（15.8%）丧失BCVA。在随访相似的观察组中，87.5%的患眼显示BCVA随时间稳定或恶化。IMP和IVTA联合治疗可在最短随访12个月时为IPFT组2A继发黄斑水肿且无CNV的患眼提供BCVA和眼底检查结果的稳定或改善。
The purpose of this study was to determine the feasibility, safety and clinical effect of indocyanine green (ICG)-mediated photothrombosis (IMP) combined with intravitreal triamcinolone acetonide (IVTA) in patients with macular edema secondary to idiopathic parafoveal telangiectasis (IPFT) group 2A without choroidal neovascularization (CNV).Nine eyes of six patients that were treated with IMP immediately followed by IVTA at a dose of 4 mg participated in the study. Patients had a mean follow-up of 23.3 months (range 12-36 months). Patients underwent one or two sessions of IMP combined with IVTA ("study group"). An IVTA-only group of 19 eyes from 14 patients with macular edema secondary to IPFT group 2A that underwent an IVTA 4 mg without IMP ("IVTA-only group") was included for comparison. In addition, a matched control group of 40 eyes from 20 patients selected retrospectively from our medical records with macular edema secondary to IPFT group 2A without any therapy was included ("observation group").The best-corrected visual acuity (BCVA) remained stable in five eyes (55.5%). Four eyes (44.4%) demonstrated improvement of BCVA (>= two ETDRS lines), and no eyes experienced worsening of visual acuity (>= two ETDRS lines). A significant decrease in hyperfluorescence was not seen with fluorescein angiography (FA), however optical coherence tomography (OCT) showed a decrease in the size of inner intraretinal hyporeflective spaces or cystic edema. Two (22.2%) eyes developed an increase in intraocular pressure. However, it was medically controlled with topical anti-glaucoma medications. Cataract developed in five eyes (55.5%). Six of nine eyes (66.6%) required one retreatment during the study period. At the last follow-up (mean 21.1 months, range 12-30 months) in the IVTA-only group, 5 (25.3%) eyes improved BCVA, 11 (57.9%) eyes remained within two lines of baseline BCVA and 3 (15.8%) eyes lost BCVA. In the observation group, with similar follow-up, 87.5% of eyes showed either stabilization or deterioration of BCVA over time.Combined IMP and IVTA may provide stability or improvement in BCVA and fundus findings in eyes with macular edema secondary to IPFT group 2A without CNV at a minimum follow-up of 12 months.