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.

玻璃体内注射高剂量的曲安奈德后的感染性和非感染性眼内炎

PURPOSE: To evaluate the rate of infectious and noninfectious endophthalmitis after intravitreal injection of a high-dosage of triamcinolone acetonide. DESIGN: Clinical interventional case-series study. METHODS: The study included 1135 intravitreal injections of approximately 20 mg triamcinolone performed for 915 eyes with diabetic macular edema (n=257),exudative age-related macular degeneration (n=561),retinal vein occlusions (n=82),and other reasons. Among the injections were 220 reinjections. Triamcinolone was filtered to remove the solvent agent. Mean follow-up was 8.1± 7.4 months. RESULTS: In none of the eyes,signs of an infectious or noninfectious endophthalmitis were observed such as noncrystalline hypopyon,cellular infiltration,or amorphous opacification of the vitreous,retinal infiltration,or pain. One patient developed infectious endophthalmitis 2 days after a traumatic rupture of a previous corneoscleral cataract incision. CONCLUSIONS: The rate of infectious or noninfectious endophthalmitis after an intravitreal high-dosage triamcinolone injection may be approximately 1:1000,if the solvent agent was removed.

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.

玻璃体内大剂量反复注射曲安奈德的安全性

To report side effects after intravitreal high-dose reinjections of triamcino lone acetonide. Clinical interventional case series. Forty-six patients (47 eye s) received at least two intravitreal injections of approximately 20 to 25 mg tr iamcinolone acetonide for treatment of diabetic macular edema (n=6 eyes), exudat ive age-related macular degeneration (n=23), and other diseases. Intervals betw een injections were 6.7 ±3.4 months, 8.0 ±4.6 months, and 10.2 months, respect ively, before the second (n=47 eyes), third (n=9), and fourth (n=2) injection. M ean follow-up was 20.7±8.9 months. After no reinjection were complications det ected, other than those known to occur after a single intravitreal injection. Af ter the first, second, and third injection, respectively, intraocular pressure r emained normal in 24 (51%), 25 (53%), and 26(56%)eyes. Intravitreal high-dos age reinjections of triamcinolone acetonide may be tolerated within a mean follo w-up of approximately 21 months.

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.