Intravitreal triamcinolone acetonide for treatment of cystoid macular oedema in patients with retinitis pigmentosa
Intravitreal triamcinolone acetonide for treatment of cystoid macular oedema in patients with retinitis pigmentosa
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DOI：
10.1111/j.1600-0420.2005.00395.x
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发表时间：
2005-04-01
期刊：
影响因子：
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通讯作者：
Karacorlu, S
中科院分区：
文献类型：
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作者：
Ozdemir, H;Karacorlu, M;Karacorlu, S
目的：目的：探讨玻璃体腔内注射曲安奈德治疗视网膜色素变性（RP）继发黄斑囊样水肿（CMO）的解剖及视力效果。所有患眼均出现持续性CMO，尽管药物治疗为250 mg口服乙酰唑胺，每日两次，持续1个月。玻璃体内注射4 mg（0.1 ml）曲安奈德治疗黄斑水肿。视觉和解剖反应进行了观察，以及并发症相关的注射程序和皮质类固醇medication.Results：随访期6至8个月不等（平均6.8个月），所有患者完成6个月的随访。玻璃体腔注射曲安奈德后，所有患者均表现出良好的解剖反应。基线中心黄斑厚度中位数为418 μ m（范围376-626 η m）。在1个月时，中央黄斑厚度中位数已降至224 μ m（范围214-326 μ m）。在3个月和6个月时，中心黄斑厚度中位数分别为275 μ m（范围215-584 μ m）和312 μ m（范围239-521 μ m）。1例患者在3个月随访时发现CMO复发，2例患者在6个月随访时发现CMO复发。对这些患者进行了再治疗。在1个月的随访中，没有发现患者视力丧失，2例患者显示出改善。在3个月和6个月的随访中，没有患者从基线视力下降，但没有患者保持其改善的视力（VA）。结论：在我们的小系列，所有患者表现出的解剖改善后，玻璃体内注射曲安奈德的CMO。然而，5例患者中有3例尽管解剖结果良好，但VA没有改善。由于这项初步研究的局限性，很难解释为什么尽管一些患者的解剖结果良好，但VA没有改善。需要更长的随访时间和更大的系列研究来评估治疗的有效性。
Purpose: To evaluate the anatomic and visual outcomes of intravitreal triamcinolone acetonide injection in patients with cystoid macular oedema (CMO) secondary to retinitis pigmentosa (RP).Methods: Five eyes of five patients with CMO secondary to RP, aged 25-41 years (mean 33.2 years) made up the study population. All eyes had persistent CMO despite medical treatment with 250 mg of oral acetazolamide twice daily for 1 month. Intravitreal injection of 4 mg (0.1 ml) triamcinolone acetonide was offered to treat macular oedema. The visual and anatomic responses were observed, as well as complications related to the injection procedure and corticosteroid medication.Results: Follow-up periods varied between 6 and 8 months (mean 6.8 months); all patients completed 6 months of follow-up. After intravitreal triamcinolone acetonide injection all patients showed good anatomic response. The baseline median central macular thickness was 418 mu m (range 376-626 eta m). At 1 month, the median central macular thickness had decreased to 224 mu m (range 214-326 mu m). At 3 and 6 months, the median central macular thicknesses were 275 mu m (range 215-584 mu m) and 312 mu m (range 239-521 mu m), respectively. Recurrent CMO was found in one patient at the 3-month follow-up and in two patients at the 6-month follow-up. Retreatment was performed in these patients. At the 1-month follow-up, no patient was found to have lost vision and two patients showed improvement. At the 3- and 6-month follow-ups, no patient had lost vision from baseline but no patient had maintained their improved visual acuity (VA).Conclusions: In our small series, all patients showed an anatomic improvement in CMO after intravitreal injection of triamcinolone acetonide. However, in three out of five patients, despite good anatomic results, no improvement in VA was achieved. Because of the limitations of this pilot study, it is difficult to explain why no improvement in VA was achieved despite good anatomic results in some patients. Further study with longer follow-up periods and larger series is warranted to assess the efficacy of the treatment.