Avtor/Urednik     Kraut, Aleksandra
Naslov     Triamcinolon intravitrealno v zdravljenju cistoidnega edema makule
Prevedeni naslov     Intravitreal triamcinolone for the treatment of cystoid macular oedema
Tip     članek
Vir     Zdrav Vestn
Vol. in št.     Letnik 74, št. 10
Leto izdaje     2005
Obseg     str. 579-82
ISSN     1318-0347
Jezik     slo
Abstrakt     Background. Longstanding cystoid macular oedema (CME) can result in loss of central vision, and there are only limited therapeutic possibilities. The aim of this article is to report clinical outcome of our patients with CME treated with intravitreal application of triamcinolone acetonide. Methods. Prospective clinical interventional non-comparative case study of patients, treated for CME in 2004 in Eye Clinic of Ljubljana. There were 15 patients (16 eyes) in the 1-16 months, follow-up study. Patients received an intravitreal injection of 4 mg (0,1 ml) triamcinolone acetonide transconjunctivally with topical anesthesia. The visual and anatomic responses were observed as well as related potentional complications. Results. Causes of CME' were: cataract surgery in 6 patients, branch retinal vein occlusion in 5 patients, uveitis in 2 patients, and diabetes and age related macular degeneration respectively in one patient. Age of patients was between 27 to 85 years, mean 69 years. Visual acuity before the treatment was from 0.017 to 0.6, mean 0.2. After the treatment visual acuity was from 0.017 to 1.0 mean 0.32. In patient series after cataract operation mean visual acuity before therapy was 0.12 and, final 0.36 and in uveitis group 0.32 and final 0.42. In other CME, forms there was insignificant visual improvement. In 2 patients (13%) increased intraocular preasure was found and treatment with topical ocular hypertensive agents was sufficient In one patient progressive cataract was established, and in one patient retinal fibrosis in the macula and around thrombotic vein was, found. Conclusions. Intravitreal triamcinolone application is probably a good and safe therapeutic possibility for CME, the risk of serious adverse events considering good technique of injections is low. In our series of patients best results were found in patients after cataract surgery and uveitis. However, the observed series is too small to bring final conclusions.
Izvleček     Izhodišča. Dolgotrajni cistoidni makularni edem (CME:) lahko vodi v izgubo centralnega vida, možnosti zdravljenja pa so omejene. V članku želimo prikazati klinični izid zdravljenja naših bolnikov s CME po intravitrealnem dajartju triamcinolon acetonida. Metode. Prospektivna klinična intervencijska neprimerjalna študija o bolnikih, ki smo jih v letu 2004 zdravili na Očesni kliniki Ljubljana zaradi CME. Zajema ZS bolnikov (16 oči), opazovano obdobje je od 1 do 16 mesecev. Bolniki so prejeli intravitrealno injekcijo 4 mg (0,1 ml) triamcinolon acetonida transkonjunktivalno v lokalni anesteziji. Opazovali smo vizualne in anatomske odzive in možne zaplete zdravljenja. Rezultati. Vzroki CME so bili: pri 6 bolnikih operacija katarakte, pri 5 bolnikih delna zapora veje retinalne vene pri 2 bolnikih uveitis in pri 1 bolniku sladkorna bolezen oziroma starostna degeneracija makule. Starost bolnikov se je gibala med 27 in 85leti, povprečna je bila 69 let. Vidna ostrina pred zdravljenjem je bila od 0, O17 do 0,6, povprečna 0,2. Po zdravljenju je bila vidna ostrina od 0,017 7 do 1,0, povprečna 0,32. V seriji bolnikov po operaciji katarakte je bila povprečna vidna ostrina pred zdravljenjem 0,12 in končna 0,36, uveitisov 0,32 in končna 0,45. Pri drugih oblikah CME je bilo izboljšanje vida zanemarljivo. Povišan očesni tlak sta imela 2 bolnika (13%) zadoščalo je lokalno zdravljenje z antihipertenzivi. Ena bolnica je imela napredujočo katarakto in ena bolnica fibrozo mrežnice v makuli in ob trombozirani veni. Zaključki. Intravitrealna raba triamcinolona je verjetno dobra in varna terapevtska možnost za CME tveganje za hude stranske učinke je ob upoštevanju dobro izdelane tehnike dajanja injekcij sorazmerno majhno. V naši seriji bolnikov smo bili najbolj uspešni pri CME po operaciji katarakte in pri uveitisu, vendar je proučevana skupina premajhna za dokončne zakjučke.
Deskriptorji     MACULAR EDEMA, CYSTOID
TRIAMCINOLONE
VISUAL ACUITY
TREATMENT OUTCOME