RESUMO
·AIM: To evaluate the efficacy and safety of intravitreal triamcinolone acetonide(TA) as treatment for macular edema associated with retinal vein occlusion(RVO).·METHODS: The study group consisting 30 patients (30 eyes) with RVO combined with macular edema received intravitreal 4mg TA. Changes in best-corrected visual acuity (BCVA), intraocular pressure(IOP), examination with slit-lamp microscope, fluorescein angiography and optical coherence tomography(OCT) were observed during the follow-up. Statistical analysis was conducted with SPSS 12.0 software.·RESULTS: The visual acuity(VA) of all patients was significantly improved and the central macular thickness (CMT) was significantly relieved. There was no correlation between course, age, CMT before injection and the type of RVO. There was positive correlation between visual acuity before injection and after injection.·CONCLUSION: Intravitreal injection of TA is an easy-operated and safe therapy. After injection, macular edema can be rapidly relieved. VA at baseline is the predictor for the prognosis of VA. Some patients experience recurrence of macular edema between 3 to 6 months after injection.
RESUMO
Central serous chorioretinopathy (CSC) is characterized by serous detachment of the sensory retina as a consequence of the focal leakage of fluid from the choriocapillaries to subretinal space through a defect of the retinal pigment epithelium(RPE). The exact cause of CSC is not well unknown. Psychological stress is thought to contribute to CSC, but the physiologic mechanisms are unclear. It is hypothesized that psychological stress can induce CSC through the mechanism of the hypothalamic-pituitary-adrenal (HPA) system. Psychological stress can adversely affect HPA axis and causes glucocorticoid levels to elevate. Increased glucocorticoids constrict choroid vessels, which leads to ischemia of choroids and damage vascular endothelial cells, thus causing vasopermeability to increase. RPE dysfunction will occur as a result of abnormalities in the choroidal circulation. The large molecules including protein may enter the subretinal space through the damaged vessels and RPE.
RESUMO
<p><b>OBJECTIVE</b>To observe the clinical manifestations of bullous retinal detachment and analyze the etiological factors.</p><p><b>METHODS</b>A retrospective analysis of the clinical data was conducted in 22 patients with multifocal retinal pigment epitheliopathy (DRPE) and big bullous retinal detachment (BBRD), who were admitted between 2003 and 2008 in Zhongshan Ophthalmic Center with the diagnoses established by ocular fundus examination, fundus fluorescein angiography (FFA) and/or indocyanine green angiography (ICGA).</p><p><b>RESULTS</b>The patients included 15 men (68%) and 7 women (32%), with a mean age at the initial visit of 42 years, ranging from 25 to 64 years. Four patients (18%) received previously systemic corticosteroid therapy, and 2 of them used corticosteroids before retina detachment, 1 suffered progression of retinal detachment after corticosteroid therapy, and the other developed retinal detachment in the healthy eye during the therapy. Multifocal bullous retinal detachment was diagnosed as diffuse pigment epitheliopathy (DRPE) in 9 cases. Most of the 13 cases of big bullous retinal detachment had poor vision after operation and laser therapy.</p><p><b>CONCLUSION</b>Bullous retinal detachment occurs most frequently in mid-life and more often in men than women. Abnormal retinal pigment epithelium (RPE) and hyperpermeability of the choroid vessels are associated with its occurrence. Systemic corticosteroid therapy and mental stress may induce and aggravate this disease. Early medication and laser therapy are effective, and surgical intervention may save only part of the vision in advanced cases.</p>