ABSTRACT
Objective To evaluate the efficacy and safety of intravitreal ranibizumab injection combined with triamcinolone acetonide (TA) for macular edema secondary to type Ⅱ optic disc vasculitis.Methods Totally 19 cases(19 eyes) with macular edema secondary to type Ⅱ optic disc vasculitis from January 2013 to December 2015 were injected ranibizumab intravitreally and triamcinolone acetonide 2 weeks later.The visual acuity,intraocular pressure,ocular fundus,OCT,FFA and related complications were observed during the 6 months follow-up period.If the macuiar edema returns during the follow-up period,the eyes would be given ranibizumab and TA again until the macular edema subsided.Results The visual acuity was 0.16 ± 0.09 and the central retinal thickness was (694.88 ± 79.06) μm before treatment.Compared with pretreatment,the visual acuity of all cases were improved in different degree except for one at 1 month,3 months and 6 months (all P ＜ 0.05).Also central retinal thickness were decreased and macular edema were subsided,there were statistical differences (all P ＜0.05).Compared with results at 1 month,the visual acuity and central retinal thickness was no significant different at 3 months and 6 months (all P ＞ 0.05).The intraocular pressure of all cases were normal throughout the follow-up period but one was increased transitorily in the first day after intravitreal rauibizumab injection.FFA examination at 1 month showed retinal hemorrhage and effusion absorbed obviously,besides,the optic disc and macular fluorescein leakage reduced significantly.The macular edema of 1 eye returned at 3 months and subsided after giving ranibizumab and TA again.The average number of injected eyes was 2.11 times.No complications associated with intravitreal injection and drugs were observed during the follow-up period.Conclusion It is effective and safe that intravitreal ranibizumab junction combined with TA for macular edema secondary to type Ⅱ optic disc vasculitis,which not only shorten the period of treatment but also reduce the times of drug injection,surgical trauma and complications.
ABSTRACT
Objective To investigate the effects of Atorvastatin calcium on the incidence of macular edema after phacoemulsification in diabetic patients.Methods Forty two eyes of 42 cataract patients with diabetes and hypercholesterolemia who underwent phacoemulsification surgery were divided into interventional group (23 patients) and non-interventional group (19 patients) by random number table methods.The blood glucose and pressure of patients in two groups was controlled strictly before and after surgery.10 mg Atorvastatin calcium per day was delivered one day after cataract surgery for the patients of interventional group and used for 24 weeks.No lipid-lowing agent was provided to the patients of non-interventional group.The main outcome measures included the best corrected visual acuity (BCVA),central retina thickness (CRT),total cholesterol (TC),low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C).No significant difference was shown in the BCVA,CRT,TC,LDL-C and HDL-C in two groups before phacoemulsification surgery (t=1.251,1.257,1.031,1.042,1.461;P＞0.05).At the end of the 24 weeks after surgery,the efficacy evaluation and comparative analysis were performed.The analysis included the BCVA,the incidence of macular edema,CRT,TC,LDL-C and HDL-C.Results The BCVA was no significantly different between two groups one day after surgery (t=1.523,P＞0.05).But 4,12,24 weeks after phacoemulsification surgery,the BCVA in interventional group was better than that in non-interventional group(t=3.920,3.012,7.025;P＜0.05).24 weeks after the operation,macular edema was occurred in 2 eyes (8.69％) in interventional group and 4 eyes (21.05 ％) in non-interventional group.Significance difference was found between two groups (x2 =4.896,P＜0.05).There was no significance different of the CRT between two groups one day after operation (t=1.501,P＞0.05).Whereas,the significance difference of the CRT was occurred in two groups 4,12,24 weeks after surgery(t=4.673,7.583,9.035;P＜0.05).Comparing with that in non-interventional group,the level of TC (t =7.043,7.930,8.611) and LDL-C (t =9.374,9.554,10.856) in interventional group was significantly decreased 4 to 24 weeks after operation (P＜0.05).But no significance different of HDL-C was shown in two groups 4,12 and 24 weeks after surgery (t=1.057,1.127,1.295;P＞ 0.05).Conclusion The treatment of Atorvastatin calcium effectively reduced the incidence rate of macular edema in hypercholesterolemia patients with good glycemic and hypertension control after phacoemulsification surgery.