Intravitreal triamcinolone for the treatment of refractory macular edema in idiopathic intermediate or posterior uveitis
Intravitreal triamcinolone for the treatment of refractory macular edema in idiopathic intermediate or posterior uveitis
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DOI：
10.1177/112067210801800318
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发表时间：
2008-05-01
影响因子：
1.7
通讯作者：
Hoyng, C. B.
中科院分区：
文献类型：
--
作者：
Hogewind, B. F. T.;Zijlstra, C.;Hoyng, C. B.
目的.黄斑囊样水肿（CME）是与特发性葡萄膜炎相关的视力丧失的最重要原因。作者报告了玻璃体内注射曲安奈德（IVTA）治疗一组因特发性中间和后葡萄膜炎引起黄斑水肿的患者。回顾性、非比较性、干预性病例系列。33只眼睛被纳入葡萄膜炎CME是难治性局部类固醇，口服泼尼松，或其组合。既往类固醇治疗未导致眼内压（IOP）升高。在评估最佳矫正视力（BCVA）和荧光素血管造影（FA）后，眼睛接受玻璃体内注射曲安奈德10 mg。在1年的随访期内定期进行眼科检查，包括FA。在注射IVTA后12周内，50%的眼睛的视力改善超过两行，30%的眼睛的IOP达到≥ 21 mmHg（p <0.01）。所有眼压升高的眼睛对局部抗青光眼药物反应良好。12个月随访后，40%的眼睛视力改善超过两行，28%的受影响的眼睛在随访期间接受了超声乳化术。术后1年内无其他并发症发生。对于特发性中间或后葡萄膜炎引起的黄斑水肿，IVTA可在前3个月内改善视力。然而，此后视力再次下降。白内障和IOP升高是常见的副作用。
PURPOSE. Cystoid macular edema (CME) is the most significant cause of visual loss associated with idiopathic uveitis. The authors report on the use of intravitreal triamcinolone acetonide (IVTA) in a group of patients with macular edema due to idiopathic intermediate and posterior uveitis.METHODS. Retrospective, noncomparative, interventional case series. Thirty-three eyes were included with uveitic CME that was refractory to topical steroids, oral prednisone, or a combination thereof. Previous steroid treatment did not result in elevated intraocular pressure (IOP). The eyes received an intravitreal injection with 10 mg triamcinolone acetonide, after best-corrected visual acuity (BCVA) and fluorescein angiography ( FA) were assessed. Ophthalmologic examination including FA was regularly performed during a 1-year follow-up period.RESULTS. Within 12 weeks after injection of IVTA, 50% of the eyes responded with an improvement in vision of more than two lines and 30% of the eyes reached an IOP of =21 mmHg (p < 0.01). All eyes with an elevated IOP responded well on topical antiglaucoma medication. After 12 months follow-up 40% of the eyes responded with an improvement in vision of more than two lines and 28% of the affected eyes underwent phacoemulsification during the follow-up. No other complications occurred within a year after the treatment.CONCLUSIONS. In macular edema due to idiopathic intermediate or posterior uveitis IVTA improves the visual acuity within the first 3 months. However, thereafter the visual acuity decreases again. Cataract and elevated IOP are common side effects.