ABSTRACT
[Objective]To investigate the etiology,clinical manifestation,treatment and prognosis of optic disc vas-culitis.[Method]Twenty-four eyes of 21 patients were enrolled in this retrospective study.Eye examinations,treatment, and effect were recorded.[Result]Six were male and 15 were female.The age was between 19 and 43 years old(average:28.7±1.6).85.7% of the patients referred to the clinic with mild to moderate decreased vision.Edema of the optic disc can be seen in both types while tortuous veins can also be found in type 2.Similar characteristics were noticed in OCT,FFA, and etc.With a follow-up of 4.52±0.98 months after treatment(prednisone:initial dose 1.0-1.2 mg/kg),the BCVA of the affected eyes improved significantly.[Conclusion]Optic disc vasculitis is affected by autoimmune disorder,infection,hy-perlipidemia,and etc.Edema of the optic disc with/without tortuous veins and retinal hemorrhage can be noticed.Similar diseases should be excluded in avoidance of misdiagnosis. Systemic examination and complete solution should be per-formed.Glucocorticoid helps to improve the visual function.The application of anti-VEGF is effective in secondary macu-lar edema.However,the long-term efficacy is awaiting being confirmed.
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.