玻璃体内注射曲安奈德治疗渗出性老年性黄斑变性非随机前瞻性对比研究

Purpose: To report on visual outcome of patients receiving an intravitreal inj ection of triamcinolone acetonide as treatment of progressive exudative age-rel ated macular degeneration. Methods: The prospective comparative nonrandomized clinical interventional study included 187 consecutive patients with progressive exudative age-related macular degeneration, divided into a study group of 115 patients receiving an intravitreal injection of 25 mg triamcinolone acetonide, and a control group of 72 patients without treatment. The mean follow-up was 6.0± 4.2 months. Results: Visual acuity increased significantly (P=0.03) in the study group, and decreased significantly (P=0.01) in the control group, at 1 month an d 3 months after start of the study. Between the study group and control group, the differences in change of visual acuity were significant (P=0.001). In the st udy group, the number of patients with an increase in visual acuity of 2 or more Snellen lines was significantly (P=0.001) larger than in the control group. Cor respondingly, the number of patients with a decrease of 2 or more Snellen lines was significantly (P=0.007) smaller in the study group. In all, 43 (37.4%) pati ents of the study group experienced an increase in best visual acuity by 2 or mo re Snellen lines. Conclusions: Visual acuity increased in patients with exudativ e age-related macular degeneration at 1 month and 3 months after an intravitrea l injection of 25 mg triamcinolone acetonide.

玻璃体腔注射曲安奈德后眼压升高

Purpose: To report on intraocular pressure (IOP) after intravitreal injections of triamcinolone acetonide. Design: Meta-analysis of previously reported data and case series studies. Participants: The study included 272 patients (305 eyes ) receiving an intravitreal injection of approximately 20 mg triamcinolone aceto nide as treatment for diffuse diabetic macular edema (n=84 patients), exudative age-related macular degeneration (n=181 patients), retinal vein occlusions (n=2 0 patients), uveitis (n=9), pseudophakic cystoid macular edema (n=6), and other reasons (n=5). Mean follow-up was 10.4±6.7 months (median, 7.9 months; range, 3.0-35.7 months). Intervention: Intravitreal injection of approximately 20 mg t riamcinolone acetonide. Main Outcome Measure: Intraocular pressure. Results: Int raocular pressure readings higher than 21 mmHg, 30 mmHg, 35 mmHg, and 40 mmHg, r espectively, were measured in 112 (41.2%) patients, 31 (11.4%) patients, 15 (5 .5%) patients, and 5 (1.8%) patients, respectively. Triamcinolone-induced IOP elevation was treated by antiglaucoma medication in all but 3 (1.0%) eyes, for which filtering surgery was performed. Mean IOP started to rise 1 week after in jection and returned to baseline values approximately 8 to 9 months after inject ion. Younger age (P=0.029)was significantly associated with triamcinolone-induc ed ocular hypertension. Triamcinolone responders and triamcinolone nonresponders did not vary significantly in gender (P=0.42), refractive error (P=0.86), diabe tes mellitus status (P=0.74), and reason for treatment. Conclusions: These findi ngs may be useful for comparing risks and benefits of intravitreal triamcinolone acetonide therapy.

光学相干断层成像及共焦激光扫描断层成像在评估黄斑水肿中的应用

Purpose To compare optical coherence tomography (OCT) and confocal scanning la ser tomography (cSLT) for quantitative retinal thickness mapping of the macula a nd their ability to detect macular edema. Design Prospective, comparative, clini cal observational study. Methods The study population of 138 eyes (97 patients) was divided into a study group consisting of 45 (32.6%) eyes with macular edema and a control group consisting of 93 (67.4%) eyes without macular edema. All p atients underwent OCT and cSLT of the macula. Retinal thickness measurements obt ained by OCT were compared with signal width and edema index, determined by cSLT . Results The OCT measurements and cSLT edema index were significantly (P< 0 .00 1) correlated with each other. Correlation coefficients decreased (P< 0.001)with increasing diameter of the measurement circle. In the macular edema group, corr elation coefficients were significantly (P< 0.001) higher than in the control gr oup. To separate the study and control groups, receiver operator characteristic curves covered a larger area for OCT measurements than for cSLT measurements. Re tinal thickness measurements and edema index correlate with visual acuity (corre lation coefficient r=-0.653 for OCT, r=-0.608 for cSLT; P < .001). Conclusions Macular edema can be quantitatively mapped by OCT and cSLT. The retinal thickne ss and edema index measurements correlate with visual acuity. The fast and stand ard examination modes of OCT give similar measurements. Both OCT and cSLT can di fferentiate between eyes with and without macular edema, with OCT showing a high er predictive value.

玻璃体腔注射曲安奈德治疗弥漫性糖尿病性黄斑水肿:一项对照的、非随机性研究

Aim: To report on visual outcome of patients receiving an intravitreal injecti on of triamcinolone acetonide for treatment of diffuse diabetic macular oedema. Methods: Prospective, comparative, non-randomised clinical interventional study included 136 patients with diffuse diabetic macular oedema. Patients of the stu dy group (97 eyes) received an intravitreal injection of 20-25 mg of triamcinol one acetonide and no other retinal treatment. Patients of the control group (69 eyes) received focal or panretinal laser treatment if indicated. Mean (standard deviation) follow up was 8.4 (SD 6.0) months (range 1.03-25.2 months). Results: Visual acuity (VA) increased significantly (p< 0.001) in the study group with 6 6 (68%) eyes gaining in VA by at least two Snellen lines. In the control group, VA did not change significantly during the first 4 months of follow up, and dec reased significantly (p< 0.001) towards the end of the follow up. Difference in change of best VA was significant (p< 0.001) between both groups. Correspondingl y, the number of patients with VA improvement of two or more Snellen lines and v isual loss of two or more Snellen lines, respectively, was significantly (p< 0.0 01) higher and lower, respectively, in the study group. Conclusions: Intravitrea l triamcinolone acetonide can temporarily increase VA in some patients with diff use diabetic macular oedema.