Effects of sub-Tenon’s triamcinolone injections in patients with uveitis

ABSTRACT Purpose: To evaluate the response to sub-Tenon’s triamcinolone injection in patients with uveitis. Methods: We studied 28 eyes with macular edema associated with controlled uveitis. We administered sub-Tenon’s injection of triamcinolone and followed the patients for 180 days to analyze the positive effects (improvement of macular edema and visual acuity) and monitor the possible adverse effects. This prospective study was conducted at the Department of Ophthalmology, Hospital de Clínicas de Porto Alegre, Brazil. Results: We observed improvement in macular edema in 86% of patients. The mean central macular thickness at each time point of assessment was 432.22, 298.80, 286.37, 267.49, 253.87, and 253.49 mm at baseline (before sub-Tenon’s injection of triamcinolone), 15 days after the procedure, at 30 days, at 60 days, at 90 days, and at 180 days, respectively. The mean reduction in retinal thickness was 30.8%, 33.7%, 38.11%, 41.2%, and 41.35% at 15, 30, 60, 90, and 180 days of follow-up, respectively. Visual acuity also improved in 85.7% of patients, with a mean improvement of 1.36, 1.93, 2.23, 2.26, and 2.30 lines gained on the Early Treatment Diabetic Retinopathy Study chart at 15, 30, 60, 90, and 180 days of follow-up, respectively. No statistically significant increases in intraocular pressure and conjunctival abnormalities were caused by the procedure, and no other adverse effects were observed. Overall, the results of this study were similar to those described in the literature. Conclusions: Sub-Tenon’s injection of triamcinolone provides reduced macular thickness and improvement in visual acuity with no significant adverse effects and is therefore an effective and safe procedure for the treatment of sequelae of uveitis.

摘要
研究目的：评估葡萄膜炎（uveitis）患者接受眼球筋膜囊下（sub-Tenon’s）曲安奈德注射后的治疗反应。
研究方法：本研究纳入28眼合并已控制型葡萄膜炎的黄斑水肿（macular edema）患者，予以眼球筋膜囊下曲安奈德注射，并对患者进行180天的随访，以分析其正向治疗效应（黄斑水肿与视力改善情况）并监测潜在不良反应。本前瞻性研究于巴西阿雷格里港临床医院眼科开展。
研究结果：86%的患者黄斑水肿得到改善。各评估时间点的平均中心黄斑厚度分别为：基线（眼球筋膜囊下曲安奈德注射前）432.22mm、术后15天298.80mm、30天286.37mm、60天267.49mm、90天253.87mm及180天253.49mm。随访15、30、60、90、180天时，患者视网膜厚度平均分别降低30.8%、33.7%、38.11%、41.2%及41.35%。视力方面，85.7%的患者视力得到改善，在随访15、30、60、90、180天时，患者于早期糖尿病视网膜病变研究（"Early Treatment Diabetic Retinopathy Study", ETDRS）视力表上平均分别提升1.36、1.93、2.23、2.26及2.30行。本操作未引发具有统计学意义的眼压（intraocular pressure）升高及结膜异常，亦未观察到其他不良反应。总体而言，本研究结果与文献报道相符。
研究结论：眼球筋膜囊下曲安奈德注射可降低黄斑厚度并改善视力，且无显著不良反应，因此是治疗葡萄膜炎后遗症的有效且安全的方案。