Posterior sub-Tenon’s steroid injections for the treatment of posterior ocular inflammation: indications, efficacy and side effects
Posterior sub-Tenon’s steroid injections for the treatment of posterior ocular inflammation: indications, efficacy and side effects
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后眼球筋膜下类固醇注射治疗眼后部炎症：适应症、疗效和副作用
DOI：
10.1007/s004170050235
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发表时间：
1999
期刊：
影响因子：
--
通讯作者：
C. Herbort
中科院分区：
文献类型：
--
作者：
Marina Lafranco Dafflon;V. Tran;Y. Guex;C. Herbort
目的
后Tenon类固醇注射(PSTSI)是治疗后段慢性葡萄膜炎的标准给药方法。本研究的目的是分析PSTSI治疗慢性葡萄膜炎的适应证、疗效和并发症。
方法
1990~1994年间，558例(58眼)葡萄膜炎患者中，53例(9.5%)在上象限接受了162次曲安奈德40 mg的PSTSI。治疗指征为视力低于或等于0.7和/或无法忍受的视力障碍。仅对PSTSI为唯一治疗参数改变的患者进行分析。分析的主要参数包括视力、房水激光耀斑光度、眼压(IOP)和并发症。
结果
葡萄膜炎的解剖部位：前葡萄膜炎伴CME 1例(1/1眼)，中间葡萄膜炎28例(28/32)，后葡萄膜炎10例(10/10)，全葡萄膜炎14例(14/15)。平均随访时间为448+/-57天。视力从0.40+/-0.03提高到0.79+/-0.07，59.4%的眼增加了2-5行Snellen行，18.7%的眼增加了>；5行。平均水耀斑光度从29.6+/-3.5降至13.6+/-2.2光子/毫秒。平均眼压由13.6+/-0.5升至18.5+/-0.8 mm Hg，并伴有眼压升高，其中23例(36%)为8 mm Hg，16例为暂时性，6例为慢性，需行滤过手术。上睑部分下垂2例，白内障进展7例。
结论
PSTSI在恢复后段慢性葡萄膜炎的视力方面非常有效，没有全身性并发症，但代价是高眼压，这种并发症比预期更常见。
PURPOSE
Posterior sub-Tenon's steroid injections (PSTSI) are a standard drug delivery method used for the treatment of chronic uveitis of the posterior segment. The aim of this study was to analyse the indications, efficacy and complications of PSTSI in the treatment of chronic uveitis.
METHODS
During the period 1990-1994, 53 (9.5%) of 558 patients (58 eyes) followed up in the uveitis clinic received a total of 162 PSTSI of triamcinolone acetonide 40 mg in the superior quadrants. Indications for treatment were vision inferior or equal to 0.7 and/or intolerable visual disturbance. Only patients in whom PSTSI were the only treatment parameter changed were analysed. Among the main parameters analysed were visual acuity, aqueous laser flare photometry, intraocular pressure (IOP) and complications.
RESULTS
Anatomical location of uveitis was as follows: anterior HLA-B27-related uveitis with CME (1 patient/1 eye), intermediate uveitis (28/32), posterior uveitis (10/10) and panuveitis (14/15). Mean duration of follow-up was 448+/-57 days. Visual acuity improved significantly from 0.40+/-0.03 to 0.79+/-0.07, with 59.4% of eyes having a gain of 2-5 Snellen lines and 18.7% a gain of >5 lines. Mean aqueous flare photometry decreased significantly from 29.6+/-3.5 to 13.6+/-2.2 photons/ms. Mean IOP increased significantly from 13.6+/-0.5 to 18.5+/-0.8 mm Hg with a rise of pressure >8 mm Hg in 23 cases (36%), transient in 16 cases, but chronic in 6 cases, needing filtering surgery. Partial superior ptosis was seen in two cases and cataract progressed in seven cases.
CONCLUSION
PSTSI are very effective in restoring visual acuity in chronic uveitis of the posterior segment, without systemic complications, but at the expense of intraocular hypertension, a complication that was found more frequently than expected.