Purpose: To evaluate prospectively the efficacy of a single sub-Tenon’ s capsule injection of triamcinolone acetonide (TA) against panretinal photocoagulation (PRP)-induced macular thickening and visual disturbance i...Purpose: To evaluate prospectively the efficacy of a single sub-Tenon’ s capsule injection of triamcinolone acetonide (TA) against panretinal photocoagulation (PRP)-induced macular thickening and visual disturbance in patients with severe diabetic retinopathy and good vision. Design: Prospective, comparative, interventional case series. Participants: Twenty eyes of 10 patients with severe nonproliferative diabetic retinopathy or non-high-risk proliferative diabetic retinopathy whose visual acuity was 20/40 or better (< 0.3 in logarithm of the minimum angle of resolution LogMAR acuity) before the PRP, whose retinopathy was bilateral and symmetrical. The averaged parafoveal retinal thickness was more than 300 μ m, leading to a worse visual prognosis after PRP. Intervention: Sub-Tenon’ s capsule injection of 20 mg TA. Main Outcome Measures: Best-corrected visual acuity (BCVA) with logMAR chart and averaged foveal thickness (FT) using the retinal mapping program of optical coherence tomography. Methods: In all patients, PRP was performed every other week for 4 sessions on both eyes, and 1 week before PRP; 1 eye received the TA injection, and the other eye served as a control. The clinical course of BCVA and FT was monitored for up to 24 weeks after beginning PRP. Results: Before TA injection, BCVA and FT were 0.055± 0.072 and 235.5± 37.5 μ m in the TA-injected eye and 0.065± 0.071 and 233.7± 39.8 μ m in the control eye, respectively; there was no significant difference between eyes. After the TA injection, FT in the TA-injected eyes was significantly decreased. During and after the PRP, FT in the control eye increased dramatically and reached 312.0± 68.2 μ m at 24 weeks, which was significantly different from that in the TA-injected eyes (235.3± 38.6 μ m at 24weeks). Best-corrected visual acuity in the control eye decreased with time to 0.24± 0.13; in contrast, and BCVA in the TA-injected eye was good (to 0.085± 0.11) . Conclusions: As a pretreatment for PRP, a single sub-Tenon’ s capsule injection of TA has beneficial effects for preventing PRP-induced foveal thickening and visual dysfunction in patients with severe diabetic retinopathy and good vision.展开更多
Background: Interferon (IFN)-associated retinopathy is typically characterize d by retinal hemorrhages and cotton wool spots at the posterior fundus, but visu al function is usually maintained. With the use of optical...Background: Interferon (IFN)-associated retinopathy is typically characterize d by retinal hemorrhages and cotton wool spots at the posterior fundus, but visu al function is usually maintained. With the use of optical coherence tomography (OCT), two patients with IFN-associated retinopathy who had developed macular e dema and reduced visual acuity during the clinical course of IFN therapy were ob served. Cases: A 37-year-old man with chronic hepatitis C and a 59-year-old man with chronic myeloid leukemia, both of whom had received IFN therapy, were r eferred to our outpatient clinic. The former patient had complained once that hi s visual acuity had decreased after the termination of IFN therapy, and the latt er patient complained twice during IFN therapy that his visual acuity had decrea sed. Observations: In both patients, at the time of the visual disturbances, mac ular edema was clearly observed by OCT. Hypoalbuminemia and thrombocytopenia wer e observed at this time also. After the remission of the hypoalbuminemia and thr ombocytopenia, the macular edema observed by OCT disappeared and visual acuity r eturned to normal. Conclusion: During and after IFN therapy, OCT is a useful exa mination technique for revealing macular edema in patients who have decreased vi sion. Ophthalmologists should be aware of the ocular side effects of IFN therapy and carefully monitor patients for the possible occurrence of hypoalbuminemia a nd thrombocytopenia.展开更多
文摘Purpose: To evaluate prospectively the efficacy of a single sub-Tenon’ s capsule injection of triamcinolone acetonide (TA) against panretinal photocoagulation (PRP)-induced macular thickening and visual disturbance in patients with severe diabetic retinopathy and good vision. Design: Prospective, comparative, interventional case series. Participants: Twenty eyes of 10 patients with severe nonproliferative diabetic retinopathy or non-high-risk proliferative diabetic retinopathy whose visual acuity was 20/40 or better (< 0.3 in logarithm of the minimum angle of resolution LogMAR acuity) before the PRP, whose retinopathy was bilateral and symmetrical. The averaged parafoveal retinal thickness was more than 300 μ m, leading to a worse visual prognosis after PRP. Intervention: Sub-Tenon’ s capsule injection of 20 mg TA. Main Outcome Measures: Best-corrected visual acuity (BCVA) with logMAR chart and averaged foveal thickness (FT) using the retinal mapping program of optical coherence tomography. Methods: In all patients, PRP was performed every other week for 4 sessions on both eyes, and 1 week before PRP; 1 eye received the TA injection, and the other eye served as a control. The clinical course of BCVA and FT was monitored for up to 24 weeks after beginning PRP. Results: Before TA injection, BCVA and FT were 0.055± 0.072 and 235.5± 37.5 μ m in the TA-injected eye and 0.065± 0.071 and 233.7± 39.8 μ m in the control eye, respectively; there was no significant difference between eyes. After the TA injection, FT in the TA-injected eyes was significantly decreased. During and after the PRP, FT in the control eye increased dramatically and reached 312.0± 68.2 μ m at 24 weeks, which was significantly different from that in the TA-injected eyes (235.3± 38.6 μ m at 24weeks). Best-corrected visual acuity in the control eye decreased with time to 0.24± 0.13; in contrast, and BCVA in the TA-injected eye was good (to 0.085± 0.11) . Conclusions: As a pretreatment for PRP, a single sub-Tenon’ s capsule injection of TA has beneficial effects for preventing PRP-induced foveal thickening and visual dysfunction in patients with severe diabetic retinopathy and good vision.
文摘Background: Interferon (IFN)-associated retinopathy is typically characterize d by retinal hemorrhages and cotton wool spots at the posterior fundus, but visu al function is usually maintained. With the use of optical coherence tomography (OCT), two patients with IFN-associated retinopathy who had developed macular e dema and reduced visual acuity during the clinical course of IFN therapy were ob served. Cases: A 37-year-old man with chronic hepatitis C and a 59-year-old man with chronic myeloid leukemia, both of whom had received IFN therapy, were r eferred to our outpatient clinic. The former patient had complained once that hi s visual acuity had decreased after the termination of IFN therapy, and the latt er patient complained twice during IFN therapy that his visual acuity had decrea sed. Observations: In both patients, at the time of the visual disturbances, mac ular edema was clearly observed by OCT. Hypoalbuminemia and thrombocytopenia wer e observed at this time also. After the remission of the hypoalbuminemia and thr ombocytopenia, the macular edema observed by OCT disappeared and visual acuity r eturned to normal. Conclusion: During and after IFN therapy, OCT is a useful exa mination technique for revealing macular edema in patients who have decreased vi sion. Ophthalmologists should be aware of the ocular side effects of IFN therapy and carefully monitor patients for the possible occurrence of hypoalbuminemia a nd thrombocytopenia.
