小剂量曲安奈德玻璃体腔重复注射的安全性观察

Safety of intravitreal low-dose reinjections of triamcinolone acetonide

目的评价小剂量曲安奈德玻璃体腔内重复注射的安全性。设计前瞻性、非对照干预研究。研究对象31例(31眼),包括黄斑水肿16例、糖尿病性黄斑水肿6例、渗出型老年黄斑变性4例、中央或分支视网膜静脉阻塞3例和非感染性葡萄膜炎2例。方法4mg曲安奈德玻璃体腔内重复注射,在距首次注射分别(2.9±1.1)个月和(4.5±2.5)个月时,分别进行了第2次(31眼)和第3次(9眼)注射,每次注射后监测视力和眼内压等。平均随访(8.4±1.6)个月。主要指标眼压、视力。结果相对于曲安奈德玻璃体腔内单次注射,重复注射并未导致特殊并发症发生。在第1、2、3次注射后分别有23(74.2%)、24(77.4%)和7(77.8%)眼眼压保持正常。3次注射后(每次)眼压的平均值之间比较无显著统计学差异。2眼(6.5%)白内障进展迅速需手术治疗。结论短期随访,小剂量曲安奈德玻璃体腔内重复注射对眼压等无明显影响。

Objective To evaluate the safety of low-dose intravitreal reinjections of triamcinolone acetonide. Design Prospective,noncomparative,interventional study. Participants 31 cases（31 eyes） ,including cystoid macular edema （ 16 cases） ,diabetic macular edema （6 causes）, exudative age-related macular degeneration （4 cases）, central or branch retinal vein occlusion （3 cases） and noninfectious uveitis （2 cases）. Methods Every time 4mg triamcinolone acetonide was injected into the vitreous cavity. Mean interval between the first injection and the second （31 cases） or third injection （9 cases） were 2.9± 1.1 months and 4.5 ± 2.5 months, respectively. Visual acuity and intraocular pressures （IOP） were measured after each injection. Mean follow-up period was 8.4±1.6 months. Main Outcome Measures Intraocular pressures, visual acuity. Results Compared with single injection, reinjections of triamcinolone acetonide had no extra complication occurred. After the first, second and third injection, respectively, intraocular pressure remained normal in 23（ 74.2 % ）, 24（ 77.4 % ） and 7（ 77.8 % ） eyes. Mean lOP had no significant difference among each post-injection in reinjections cases. 2 cases （6.5 % ） caught obvious cataract and needed surgery. Conclusion Intravitreal low-dose reinjections of triamcinolone acetonide is safe and effective during a short-term follow-up.