Intravitreal injection of crystalline cortisone as adjunctive treatment of proliferative diabetic retinopathy
Intravitreal injection of crystalline cortisone as adjunctive treatment of proliferative diabetic retinopathy
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DOI：
10.1016/s0002-9394(00)00882-5
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发表时间：
2001-04-01
影响因子：
4.2
通讯作者：
Panda-Jonas, S
中科院分区：
文献类型：
--
作者：
Jonas, JB;Hayler, JK;Panda-Jonas, S
目的：报道玻璃体平部切除术治疗增殖性糖尿病视网膜病变患者玻璃体内注射结晶可的松的临床结果和并发症。方法：前瞻性、干预性病例系列研究包括29例连续患者（29只眼），这些患者接受了玻璃体切割手术，以治疗合并中央视网膜牵引力脱离的复杂性增殖性糖尿病视网膜病变。所有患者在手术结束时接受15 - 20mg结晶曲安奈德玻璃体内注射，并由同一名外科医生进行手术。平均随访时间为1.4±1.1个月（中位1个月，范围0.30 ~ 4.9个月）。结果：随访结束时，29例患者中有26例（89.7%）视网膜附着。29例患者中有3例（10.3%）发生视网膜再脱离。12例患者术前虹膜新生血管均有轻微或明显的消退，术前、术后眼压值（P = 0.72）和血糖测量无显著差异。1例患者下前房角可见可的松晶体假性垂体，4天内自行消退。结论:目前的临床研究表明，在玻璃体切除手术治疗合并糖尿病增殖性视网膜病变时，玻璃体内注射晶体可的松并去除大部分载体似乎耐受良好。鉴于可的松的抗炎和抗增殖作用，未来的随机临床试验可能会进一步研究晶体可的松在玻璃体内注射治疗增殖性糖尿病视网膜病变中的作用。[J]中华眼科杂志，2001;31(1):468-471。(C) 2001年Elsevier Science Inc.版权所有)。
PURPOSE: To report the clinical outcome and complications of intravitreal injections of crystalline cortisone in patients undergoing pars plana vitrectomy for treatment of proliferative diabetic retinopathy.METHODS: The prospective, interventional case series study included 29 consecutive patients (29 eyes) who underwent pars plana vitrectomy for treatment of complicated proliferative diabetic retinopathy associated with central retinal traction detachment. All patients received an intravitreal injection of 15 to 20 mg of crystalline triamcinolone acetonide at the end of surgery, and were operated on by the same surgeon. Mean follow-up time was 1.4 +/- 1.1 months (median, 1 month; range, 0.30 to 4.9 months).RESULTS: At the end of the follow-up period, the retina was attached in 26 of the 29 patients (89.7%). In three of the 29 patients (10.3%), a retinal redetachment had occurred. None of the patients developed iris neovascularization, and the iris neovascularization, present preoperatively in 12 patients, slightly to markedly regressed in all 12 patients, Preoperative and postoperative intraocular pressure values (P = .72) and blood glucose measurements did not vary significantly. A pseudohypopyon consisting of cortisone crystals in the inferior anterior chamber angle was detected in one patient and resolved spontaneously within 4 days.CONCLUSIONS: The present clinical study suggests that intravitreal injection of crystalline cortisone with most of the vehicle removed seems to be well tolerated by eyes undergoing pars plana vitrectomy for treatment of complicated diabetic proliferative retinopathy, In view of the antiphlogistic and antiproliferative effect of cortisone, future randomized clinical trials may be indicated to investigate further the role of intravitreal injection of crystalline cortisone in the treatment of proliferative diabetic retinopathy. (Am J Ophthalmol 2001;131:468-471. (C) 2001 by Elsevier Science Inc. All rights reserved).