Purpose. To evaluate the effect of intravitreal triamcinolone acetonide on visual acuity in branch retinal vein occlusion. Methods. The prospective comparative nonrandomized clinical interventional study included 28 p...Purpose. To evaluate the effect of intravitreal triamcinolone acetonide on visual acuity in branch retinal vein occlusion. Methods. The prospective comparative nonrandomized clinical interventional study included 28 patients (28 eyes) with branch retinal vein occlusion. The study group consisting of 10 consecutive patients received an intravitreal injection of 20- 25mg of triamcinolone acetonide. The control group including 18 patients did not receive an intravitreal injection. The mean follow-up was 8.7± 4.4 months. Results. In the study group, mean visual acuity increased significantly (P=0.02) from 0.27± 0.11 preoperatively to a best postoperative visual acuity of 0.45± 0.27. Visual acuity measurements determined 1 month after the injection were significantly (P=0.027) higher than baseline values. Nine (90% ) eyes gained in visual acuity, with six (60% ) eyes showing an increase in visual acuity of at least two Snellen lines. In the ischaemic subgroup, visual acuity did not change significantly (0.18± 0.18 to 0.13± 0.04; P=0.66), while, in the nonischaemic subgroup, visual acuity increased significantly (P=0.012) from the baseline value to the best postoperative measurement (0.29± 0.09 to 0.53± 0.24). In the control group, baseline visual acuity and best visual acuity during the follow-up did not vary significantly (P=0.27). Comparing the study and control groups with each other, the gain in visual acuity was significantly higher in the study group at 1 month (P=0.016) and 2 months (P=0.012) after baseline. Conclusions. Intravitreal injection of triamcinolone acetonide can increase visual acuity in patients with branch retinal vein occlusion.展开更多
Purpose: To evaluate posterior subtenon injection of triamcinolone acetonide for refractory diabetic macular edema (DME). Design: Retrospective, interventional, case series. Methods: setting: Clinical practice. patien...Purpose: To evaluate posterior subtenon injection of triamcinolone acetonide for refractory diabetic macular edema (DME). Design: Retrospective, interventional, case series. Methods: setting: Clinical practice. patient population: Patients with persistent clinically significant DME involving the center of the fovea 3 or more months after one or more treatments of focal macular photocoagulation were included. Exclusion criteria were a history of corticosteroid- responsive intraocular pressure (IOP) rise, intraocular surgery within 3 months, and any laser treatment within 1 month. procedure: All patients received an ophthalmic history and examination including best- corrected Snellen visual acuity, IOP measurement, anterior segment examination including evaluation of lens status with LOCS II criteria, dilated fundus examination, and a posterior subtenon injection of 40mg triamcinolone acetonide at baseline. Patients were reevaluated at 1, 3, 6, and 12 months after injection. Results: Seventy- three injections were performed in 63 eyes of 50 patients. The mean baseline visual acuity was 20/80. Mean visual acuity significantly improved to 20/50 at 1 month, then stabilized to 20/65 at 3 months, 20/68 at 6 months, and 20/63 at 12 months. Complication swere rare,with a transient significant rise in intraocular pressure at the 3- month evaluation and ptosis in two patients. Conclusions: Visual acuities remained stable or improved over a 12- month period after posterior subtenon triamcinolone injections for refractory DME. There was a statistically significant improvement in visual acuity at 1 month.展开更多
PURPOSE: The effectiveness of intravitreal triamcinolone acetonide in the treatment of cystoid macular edema from central retinal vein occlusion (CRVO) was investigated. DESIGN: A noncomparative, prospective, interven...PURPOSE: The effectiveness of intravitreal triamcinolone acetonide in the treatment of cystoid macular edema from central retinal vein occlusion (CRVO) was investigated. DESIGN: A noncomparative, prospective, interventional case series. METHODS: In a clinical practice, 18 patients were enrolled with nonischemic CRVO and cystoid macular edema. Two milligrams of triamcinolone acetonide were injected into the vitreous of only one eye from each patient. The outcome measures were 1-mm mean central retinal thickness on optical coherence tomography and visual acuity. RESULTS: Mean duration of symptoms before surgery was 2 months (SD, 1.3 months). Ten patients required repeated injections for recurrent cystoidmacular edema (mean,1.8 injections). Mean visual acuity significantly improved from 20/300 to 20/166 (P=.007) at 1 month, 20/100 (P=.0005) at 2 months, 20/130 (P=.007) at 3 months, and 20/150 (P=.02) at 6 months but deteriorated again to 20/270 (not significant) at 12 months. There was a significant improvement in retinal thickness from presentation 518 μm, to 363 μm (P=.03) at 1 month, 304 μm (P=.04) at 2 months, and 353 μm (P=.01) at 3 months but not from presentation at 6 months (mean, 383 μm) and 12 months (mean, 406 μm). Eleven patients suffered intraocular pressure rises requiring intervention. Intravitreal triamcinolone acetonide did not prevent collateral circulation formation, which was seen in 10 patients. CONCLUSION: Intravitreal corticosteroid injection is very effective in reversing cystoid macular edema and improving visual acuity in recent-onset nonischemic CRVO in the first 6 months, but this is unfortunately not sustained at 1 year.展开更多
PURPOSE: To evaluate complications and results of intravitreal triamcinolone acetonide for treatment of macular edema. DESIGN: Interventional, consecutive, retrospective case series. METHODS: Ninety-three eyes with ma...PURPOSE: To evaluate complications and results of intravitreal triamcinolone acetonide for treatment of macular edema. DESIGN: Interventional, consecutive, retrospective case series. METHODS: Ninety-three eyes with macular edema arising from retinovascular etiologies were treated with 4 mg intravitreal triamcinolone. Eyes were monitored after injection for visual acuity changes and complications, including cataract formation and increase in intraocular pressure (IOP). Cataract progression was analyzed by linear regression analysis of lens scores from lens opacity standards. RESULTS: The mean visual acuity improved from 20/125 to- 1 to 20/100+ 2 by one to two months after injection (P < .001) and was 20/100 at the final examination (P=.006) at a mean of 1.2 years after injection. Complications included a severe, culture-negative inflammatory reaction in one eye (1.1% ). IOP increased to 30 mm Hg or more in nine (9.7% ) of 93 eyes between 1 and 140 days after injection and wasmore frequent in eyes receiving one or more preinjection glaucoma drops (two of 13 eyes, 15.4% , vs seven of 80 eyes, 8.75% , without preinjection glaucoma drops). Nuclear sclerosis increased at a rate of 0.175 U per year, posterior subcapsular cataracts at 0.423 U per year, and cortical cataracts at 0.045U per year. Posterior subcapsular cataract increased by ≥ 1 U or required cataract surgery in 45.2% of eyes followed at least one year. CONCLUSIONS: Intravitreal triamcinolone improves visual acuity in most eyes but eyes must be monitored carefully for increase in IOP. Posterior subcapsular cataract formation becomes visually significant in almost half of eyes by one year after injection.展开更多
Purpose: To evaluate treatment of macular oedema due to central retinal vein o cclusion (CRVO) with intravitreal triamcinolone acetonide. Methods: In a prospec tive case series, 13 patients with macular oedema due to ...Purpose: To evaluate treatment of macular oedema due to central retinal vein o cclusion (CRVO) with intravitreal triamcinolone acetonide. Methods: In a prospec tive case series, 13 patients with macular oedema due to non-ischaemic CRVO rec eived an intravitreal injection of 4 mg triamcinolone acetonide. Examination inc luded assessment of best corrected visual acuity (BCVA) for distance and reading , measurement of intraocular pressure (IOP), fluorescein angiography and high re solution imaging by optical coherence tomography, preoperatively and 1 week, 1 m onth, 3, 6 and 9 months postoperatively. Results: Preoperative mean BCVA was 0.9 ±0.4 for distance vision and 1.0±0.3 for reading acuity, respectively. A signi ficant improvement in distance VA (0.5±0.3, p< 0.001) and reading acuity (0.7± 0.3, p=0.03) was observed until 3 months and 6 months, respectively. Mean macula r thickness was significantly reduced until 9 months postoperatively. Conclusion : Intravitreal injection of triamcinolone acetonide led to a significant improve ment in mean VA in patients with macular oedema due to CRVO. However, the signif icant effect was not permanent and persisted for a maximum of 6 months.展开更多
文摘Purpose. To evaluate the effect of intravitreal triamcinolone acetonide on visual acuity in branch retinal vein occlusion. Methods. The prospective comparative nonrandomized clinical interventional study included 28 patients (28 eyes) with branch retinal vein occlusion. The study group consisting of 10 consecutive patients received an intravitreal injection of 20- 25mg of triamcinolone acetonide. The control group including 18 patients did not receive an intravitreal injection. The mean follow-up was 8.7± 4.4 months. Results. In the study group, mean visual acuity increased significantly (P=0.02) from 0.27± 0.11 preoperatively to a best postoperative visual acuity of 0.45± 0.27. Visual acuity measurements determined 1 month after the injection were significantly (P=0.027) higher than baseline values. Nine (90% ) eyes gained in visual acuity, with six (60% ) eyes showing an increase in visual acuity of at least two Snellen lines. In the ischaemic subgroup, visual acuity did not change significantly (0.18± 0.18 to 0.13± 0.04; P=0.66), while, in the nonischaemic subgroup, visual acuity increased significantly (P=0.012) from the baseline value to the best postoperative measurement (0.29± 0.09 to 0.53± 0.24). In the control group, baseline visual acuity and best visual acuity during the follow-up did not vary significantly (P=0.27). Comparing the study and control groups with each other, the gain in visual acuity was significantly higher in the study group at 1 month (P=0.016) and 2 months (P=0.012) after baseline. Conclusions. Intravitreal injection of triamcinolone acetonide can increase visual acuity in patients with branch retinal vein occlusion.
文摘Purpose: To evaluate posterior subtenon injection of triamcinolone acetonide for refractory diabetic macular edema (DME). Design: Retrospective, interventional, case series. Methods: setting: Clinical practice. patient population: Patients with persistent clinically significant DME involving the center of the fovea 3 or more months after one or more treatments of focal macular photocoagulation were included. Exclusion criteria were a history of corticosteroid- responsive intraocular pressure (IOP) rise, intraocular surgery within 3 months, and any laser treatment within 1 month. procedure: All patients received an ophthalmic history and examination including best- corrected Snellen visual acuity, IOP measurement, anterior segment examination including evaluation of lens status with LOCS II criteria, dilated fundus examination, and a posterior subtenon injection of 40mg triamcinolone acetonide at baseline. Patients were reevaluated at 1, 3, 6, and 12 months after injection. Results: Seventy- three injections were performed in 63 eyes of 50 patients. The mean baseline visual acuity was 20/80. Mean visual acuity significantly improved to 20/50 at 1 month, then stabilized to 20/65 at 3 months, 20/68 at 6 months, and 20/63 at 12 months. Complication swere rare,with a transient significant rise in intraocular pressure at the 3- month evaluation and ptosis in two patients. Conclusions: Visual acuities remained stable or improved over a 12- month period after posterior subtenon triamcinolone injections for refractory DME. There was a statistically significant improvement in visual acuity at 1 month.
文摘PURPOSE: The effectiveness of intravitreal triamcinolone acetonide in the treatment of cystoid macular edema from central retinal vein occlusion (CRVO) was investigated. DESIGN: A noncomparative, prospective, interventional case series. METHODS: In a clinical practice, 18 patients were enrolled with nonischemic CRVO and cystoid macular edema. Two milligrams of triamcinolone acetonide were injected into the vitreous of only one eye from each patient. The outcome measures were 1-mm mean central retinal thickness on optical coherence tomography and visual acuity. RESULTS: Mean duration of symptoms before surgery was 2 months (SD, 1.3 months). Ten patients required repeated injections for recurrent cystoidmacular edema (mean,1.8 injections). Mean visual acuity significantly improved from 20/300 to 20/166 (P=.007) at 1 month, 20/100 (P=.0005) at 2 months, 20/130 (P=.007) at 3 months, and 20/150 (P=.02) at 6 months but deteriorated again to 20/270 (not significant) at 12 months. There was a significant improvement in retinal thickness from presentation 518 μm, to 363 μm (P=.03) at 1 month, 304 μm (P=.04) at 2 months, and 353 μm (P=.01) at 3 months but not from presentation at 6 months (mean, 383 μm) and 12 months (mean, 406 μm). Eleven patients suffered intraocular pressure rises requiring intervention. Intravitreal triamcinolone acetonide did not prevent collateral circulation formation, which was seen in 10 patients. CONCLUSION: Intravitreal corticosteroid injection is very effective in reversing cystoid macular edema and improving visual acuity in recent-onset nonischemic CRVO in the first 6 months, but this is unfortunately not sustained at 1 year.
文摘PURPOSE: To evaluate complications and results of intravitreal triamcinolone acetonide for treatment of macular edema. DESIGN: Interventional, consecutive, retrospective case series. METHODS: Ninety-three eyes with macular edema arising from retinovascular etiologies were treated with 4 mg intravitreal triamcinolone. Eyes were monitored after injection for visual acuity changes and complications, including cataract formation and increase in intraocular pressure (IOP). Cataract progression was analyzed by linear regression analysis of lens scores from lens opacity standards. RESULTS: The mean visual acuity improved from 20/125 to- 1 to 20/100+ 2 by one to two months after injection (P < .001) and was 20/100 at the final examination (P=.006) at a mean of 1.2 years after injection. Complications included a severe, culture-negative inflammatory reaction in one eye (1.1% ). IOP increased to 30 mm Hg or more in nine (9.7% ) of 93 eyes between 1 and 140 days after injection and wasmore frequent in eyes receiving one or more preinjection glaucoma drops (two of 13 eyes, 15.4% , vs seven of 80 eyes, 8.75% , without preinjection glaucoma drops). Nuclear sclerosis increased at a rate of 0.175 U per year, posterior subcapsular cataracts at 0.423 U per year, and cortical cataracts at 0.045U per year. Posterior subcapsular cataract increased by ≥ 1 U or required cataract surgery in 45.2% of eyes followed at least one year. CONCLUSIONS: Intravitreal triamcinolone improves visual acuity in most eyes but eyes must be monitored carefully for increase in IOP. Posterior subcapsular cataract formation becomes visually significant in almost half of eyes by one year after injection.
文摘Purpose: To evaluate treatment of macular oedema due to central retinal vein o cclusion (CRVO) with intravitreal triamcinolone acetonide. Methods: In a prospec tive case series, 13 patients with macular oedema due to non-ischaemic CRVO rec eived an intravitreal injection of 4 mg triamcinolone acetonide. Examination inc luded assessment of best corrected visual acuity (BCVA) for distance and reading , measurement of intraocular pressure (IOP), fluorescein angiography and high re solution imaging by optical coherence tomography, preoperatively and 1 week, 1 m onth, 3, 6 and 9 months postoperatively. Results: Preoperative mean BCVA was 0.9 ±0.4 for distance vision and 1.0±0.3 for reading acuity, respectively. A signi ficant improvement in distance VA (0.5±0.3, p< 0.001) and reading acuity (0.7± 0.3, p=0.03) was observed until 3 months and 6 months, respectively. Mean macula r thickness was significantly reduced until 9 months postoperatively. Conclusion : Intravitreal injection of triamcinolone acetonide led to a significant improve ment in mean VA in patients with macular oedema due to CRVO. However, the signif icant effect was not permanent and persisted for a maximum of 6 months.
