Zusammenfassung
Hintergrund
Wir untersuchten die Wirkung einer intravitrealen Injektion von 4 mg Triamcinolon hinsichtlich Visusverlauf und Verlauf des Makulaödems und verglichen die Wirkung bei Makulaödemen unterschiedlicher vaskulärer Genese.
Material und Methode
In diese prospektive Pilot-Studie wurden Patienten mit Astvenenthrombose (Gruppe A: 9 Patienten), Zentralvenenthrombose (Gruppe B: 13 Patienten), oder mit diabetischem Makulaödem (Gruppe C: 12 Patienten) aufgenommen. Die Patienten erhielten eine intravitreale Injektion von 4 mg Triamcinolon-Acetonid. Kontrolluntersuchungen wurden 1 Tag präoperativ, 1 Woche, 1 Monat, 3, 6 (Gruppe A) und 9 Monate (Gruppe B und C) postoperativ durchgeführt. Die Patienten wurden an der Spaltlampe untersucht, Fernvisus (in LogMar) und Nahvisus (in LogRad) wurden bestimmt und die Dicke der Makula wurde mittels optischer Kohärenztomographie (OCT) gemessen.
Resultate
Eine signifikante Visusverbesserung war bis zu 1 Monat postoperativ in Gruppe A (Astvenenthrombose), bis zu 6 Monaten postoperativ in Gruppe B (Zentralvenenthrombose) und bis zu 1 Monat postoperativ in Gruppe C (diabetisches Makulaödem) zu beobachten.
Schlussfolgerung
Die signifikante Wirkung einer einzelnen intravitrealen Triamcinolon-lnjektion ist nicht dauerhaft. Ob diese Methode für bestimmte Patientengruppen trotzdem eine therapeutische Option darstellt, sollte in prospektiven Kontrollstudien geprüft werden.
Summary
Background
To evaluate the influence of intravitreal triamcinolone acetonide on visual acuity and macular thickness of patients with vascular diseases and macular edema.
Methods
Patients with branch retinal vein occlusion (group A: 9 patients), with central retinal vein occlusion (group B: 13 patients) and patients with diabetic macular edema (group C: 12 patients) were included. Patients received an intravitreal injection of 4 mg triamcinolone acetonide. Follow-up examinations were performed at 1 day preoperatively, 1 week, 1 month, 3, 6 (group A) and 9 months (group B and C) after surgery and included Slit-lamp examination, assessment of intraocular pressure determined by Goldmann applanation tonometry, distance visual acuity (BCVA for distance vision in LogMar), near visual acuity (BCVA for near vision in LogRad) and macular thickness using optical coherence tomography (OCT).Results: A significant effect on visual acuity and macular thickness could be observed in all groups.
Conclusion
The significant effect of a single intravitreal injection lasted for a maximum of 6 months. Randomized studies are needed to clarify if intravitreal triamcinolone acetonide may be a therapeutic option for certain groups of patients.
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Wagner, J., Sacu, S., Krepler, K. et al. Intravitreale Triamcinolon-Injektion: Vergleich zwischen Patienten mit Astvenenthrombose, Zentralvenenthrombose und diabetischem Makulaödem. Spektrum Augenheilkd 19, 18–22 (2005). https://doi.org/10.1007/BF03163196
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DOI: https://doi.org/10.1007/BF03163196