Objective:To investigate the safety and efficacy of intrav-itreal triamcinolone acetonide as t reatment for macular edema associated with central retin al vein occlusion(CRVO).Methods:We reviewed the medical re cords ...Objective:To investigate the safety and efficacy of intrav-itreal triamcinolone acetonide as t reatment for macular edema associated with central retin al vein occlusion(CRVO).Methods:We reviewed the medical re cords of13consecutive patients(13eyes)with macular edema as-sociated with CRVO who were treated w ith an injection of intravitreal triamcinolone aceton ide(4mg )at the Univer-sity of Wisconsin and the Bascom Palm er Eye Institute.Each intravitreal injection was delivered through the pars plana using a 27-or 30-gauge needle.Main Outcome Measures:Change in Snellen visual a cuity,clinical ap-pearance of macular edema,measurem ent of foveal thick-ening with optical coherence tomography(OCT),and fre-quency of complications.Results:T he median age of the 13patients was 67years(interquartile range,57-77years),and the median duration of symptoms before in-jection was 8months(interquartile range,4-9months).Mean baseline visual acuity was 20/500in the affected eye.Mean visual acuity at the 6-mont h follow-up exami-nation was 20/180in the affected eye.All 13patients completed the 6-month examination.Eyes with nonis-chemic CRVO(n =5)demonstrated a significant im-provement in visual acuity,whereas eyes with ischemic CRVO(n =8)demonstrated a nonsignificant visu al acuity improvement.No patient had a decrease in visual acuity.Mean baseline foveal thickness as me asured by OCT was590μm(retinal thickening =416μm).Mean foveal thickness as measured by OCT at the 1-month follow-up examination in 12patients was 212μm(retinal thicken-ing =38μm).At the 3-month follow-up examination,mean foveal thickness as measured by OCT for 13patients was 193μm(retinal thickening =19μm).Between the 3-and 6-month follow-up examinations,4patients developed a recurrence of macular edema.Three of the 4patients were retreated with a second injecti on of triamcinolone.Two of these 3patients experienced a n improvement in vi-sual acuity following retreatment.At the 6-month follow-up examination,mean foveal thickness as measured by OCT for13patients was 281μm(retinal thickening =107μm).No adverse effects such as retinal deta chment or endoph-thalmitis occurred.One patient exp erienced an increase in intraocular pressure that was contr olled with 2aqueous suppressants.Conclusions:Intravitreal injection of triam-cinolone appears to be a possibly effective treatment in some patients with macular edema associa ted with CRVO.Pa-tients with nonischemic CRVO may respond more favorably than patients with ischemic CRVO,an d retreatment may be necessary in some patients.In this c ase series,severe complications were not noted.展开更多
文摘Objective:To investigate the safety and efficacy of intrav-itreal triamcinolone acetonide as t reatment for macular edema associated with central retin al vein occlusion(CRVO).Methods:We reviewed the medical re cords of13consecutive patients(13eyes)with macular edema as-sociated with CRVO who were treated w ith an injection of intravitreal triamcinolone aceton ide(4mg )at the Univer-sity of Wisconsin and the Bascom Palm er Eye Institute.Each intravitreal injection was delivered through the pars plana using a 27-or 30-gauge needle.Main Outcome Measures:Change in Snellen visual a cuity,clinical ap-pearance of macular edema,measurem ent of foveal thick-ening with optical coherence tomography(OCT),and fre-quency of complications.Results:T he median age of the 13patients was 67years(interquartile range,57-77years),and the median duration of symptoms before in-jection was 8months(interquartile range,4-9months).Mean baseline visual acuity was 20/500in the affected eye.Mean visual acuity at the 6-mont h follow-up exami-nation was 20/180in the affected eye.All 13patients completed the 6-month examination.Eyes with nonis-chemic CRVO(n =5)demonstrated a significant im-provement in visual acuity,whereas eyes with ischemic CRVO(n =8)demonstrated a nonsignificant visu al acuity improvement.No patient had a decrease in visual acuity.Mean baseline foveal thickness as me asured by OCT was590μm(retinal thickening =416μm).Mean foveal thickness as measured by OCT at the 1-month follow-up examination in 12patients was 212μm(retinal thicken-ing =38μm).At the 3-month follow-up examination,mean foveal thickness as measured by OCT for 13patients was 193μm(retinal thickening =19μm).Between the 3-and 6-month follow-up examinations,4patients developed a recurrence of macular edema.Three of the 4patients were retreated with a second injecti on of triamcinolone.Two of these 3patients experienced a n improvement in vi-sual acuity following retreatment.At the 6-month follow-up examination,mean foveal thickness as measured by OCT for13patients was 281μm(retinal thickening =107μm).No adverse effects such as retinal deta chment or endoph-thalmitis occurred.One patient exp erienced an increase in intraocular pressure that was contr olled with 2aqueous suppressants.Conclusions:Intravitreal injection of triam-cinolone appears to be a possibly effective treatment in some patients with macular edema associa ted with CRVO.Pa-tients with nonischemic CRVO may respond more favorably than patients with ischemic CRVO,an d retreatment may be necessary in some patients.In this c ase series,severe complications were not noted.
