球周注射曲安奈德治疗葡萄膜炎并发黄斑水肿
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Effects of parabulbar application of triamcinolone acetonide on uveitic macular edema with or without epiretinal membranesv
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    摘要:

    目的:通过高分辨率的OCT参数(中央和平均黄斑厚度及体积)和它们与视觉效率的相关性来评估球周反复注射曲安奈德在有无视网膜前膜下对葡萄膜炎并发黄斑水肿的影响。

    方法:研究葡萄膜炎并发黄斑水肿患者共计140眼,基于有无视网膜前膜分为两组。球周每3~4wk注射一次曲安奈德(每次40mg),共注射三次,此外所有患者还接受非甾体类抗炎药物局部治疗。相关患者还进行了视觉效率、眼内压、高分辨率谱频域OCT检查。

    结果:在无视网膜前膜下黄斑水肿患者的最佳治疗效果的平均厚度、体积和中央厚度显著低于治疗前。在有视网膜前膜下黄斑水肿患者的体积和厚度值下降,中央厚度值增加。总之,后者从最初检查到完成治疗,眼内压和中央厚度没有统计意义上的显著差别,但平均厚度、体积统计意义上显著降低,而视觉效率显著增加。两组视觉效率与中央厚度密切相关。

    结论:目前球周反复注射曲安奈德在无视网膜前膜下对葡萄膜炎并发黄斑水肿更有疗效。

    Abstract:

    AIM: To do the assesement of the effects of repeated parabulbar application of triamcinolone acetonide(TA)on uveitic macular edema(ME)with and without epiretinal membranes(ERM)obtained via high resolution optical coherence tomography(OCT)parameters(central and average macular thicknesses, and volume)and their correlation with visual efficiency.

    METHODS: This study depicts treatment results obtained for 140 eyes in patients with uveitic macular edema divided into two groups based on absence or presence of epiretinal membranes. Three repeated doses of triamcinolone acetonide(40 mg each)were parabulbarlly applied every 3-4wk, and besides which all patients also received local treatment of nonsteroidal anti-inflammatory drugs. Patients' visual efficiency, intraocular pressure, and high resolution spectral domain optical coherence tomography(SD-OCT)examination was performed.

    RESULTS: Best results were achieved in patients with macular edema without epiretinal membranes where average values for average thickness, volume, and central field thickness were statistically significantly lower than the same values at the beginning of treatment. Following treatment of eyes with macular edema in a group with ERM, besides decreased values of volume and average thickness, there was also increased central field thickness. Overall, from initial examination to treatment completion, there was no statistically significant change of intraocular pressure and central field thickness, but there was statistically significant decrease in average thickness, volume, while visual efficiency statistically increased. In both groups visual efficiency highly correlated with central field thickness.

    CONCLUSION: Repeated parabulbar application of triamcinolone acetonide had better outcome on uveitic macular edema without epiretinal membranes being present.

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Jelena Paovic, Predrag Paovic, Vojislav Sredovic.球周注射曲安奈德治疗葡萄膜炎并发黄斑水肿.国际眼科杂志, 2016,16(10):1805-1811.

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  • 收稿日期:2015-11-17
  • 最后修改日期:2016-08-04
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  • 在线发布日期: 2016-09-19
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