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@#AIM:To investigate the clinical efficacy of retrobulbar or intravitreal injection of triamcinolone acetonide combined with 532nm laser photocoagulation in the treatment of diabetic macular edema(DME). <p>METHODS: Sixty-two eyes in 40 DME patients were divided into two groups(Group A and Group B)randomly. Thirty-one eyes in Group A were treated with retrobulbar injection of triamcinolone acetonide(RBTA)and 31 eyes in Group B were treated with intravitreous injection of triamcinolone acetonide(IVTA). Eyes with limited macular edema were treated by local direct retinal laser, those with diffuse and cystic macular edema were treated by grid retinal laser using Vitra 532nm fundus lasers at 1mo after injection. Visual acuity, intraocular pressure, fundus, macular edema and complications were recorded after 1wk, 1, 3 and 6mo in the follow-up study. <p>RESULTS: The mean best corrected visual acuity was improved and macular edema subsided after treatment in the two groups in the follow-up study at 1wk, 1, 3 and 6mo(<i>P</i><0.05), while there had no significant difference between groups(<i>P</i>>0.05). In Group A, significant efficiency rate was 39%(12/31), total effective rate was 90%(28/31). In Group B, significant efficiency rate was 39%(12/31), total effective rate was 94%(29/31). The follow-up study showed no retinal detachment, endophthalmitis, intraocular hemorrhage and other complications. <p>CONCLUSION: Triamcinolone acetonide injection combined with laser photocoagulation is an effective method for treatment of DME with significant effect, less adverse reactions, patient's vision improved effectively and macular edema reduced. No significant difference was noted in the treatment of DME between RBTA and IVTA.
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Retinoblastoma (RB) therapy has evolved over decades.In the 1970s, enucleation was important for improving life prognosis.In the 1980s, external beam radiotherapy (EBRT) was popular.In the 1990s, systemic intravenous chemotherapy (IVC) was introduced and currently remains prevalent worldwide for intraocular RB control as well as prevention of systemic metastasis.However, RB seeds in vitreous and subretinal space are still the major obstacles for successful treatments.Advanced ophthalmic imaging technology promotes thorough and detailed description and observation of RB seeds.In the 2000s, interests in periocular chemotherapy (POC), intra-arterial chemotherapy (IAC) and intravitreous chemotherapy (IVitC) have been explored to overcome the low drug concentration around the seeds and to reduce the systemic side effects.This leads us into a new era of target local chemotherapy of RB.How to make the treatment decision based on biological behavior of RB seeds is a major task for us now.
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Objective To investigate the treatment effect and nursing of intravitreous injection of Avastin combined with laser photocoagulation in macular edema caused by vein occlusion.Methods 38 patients(38 macular edema eyes)who had macular edema caused by retinal vein occlusion and accepted intravitreous injection of Avastin combined with laser photocoagulation were selected.Relevant nursing was given before and after the clinical treatment.The visual acuity and retinal thickness were observed and recorded.Results Visual acuity was improved in 36 eyes(94.7％),no change occurred in 2 eyes(5.3％).The thickness of macular was statistically significant compared with before treatment and 2,4,6 weeks after treatment.Conclusions Intravitreous injection of avastin combined with laser photocoagulation is effective on macular edema caused by vein occlusion.Successful treatment is guaranteed by psychological nursing,treatment guidance and health guidance.
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Objective To study the efficacy of intravitreous injection (IVI) or sub-Tenaninfusion (STi) of triamcinolone acetonide (TA) for diabetic macular oedema. Design Retrospective cases series. Participants 37 cases (37 eyes) with diabetic macular oedema confirmed by fundus fluorescence angiography (FFA) and optical coherence tomography (OCT). Methods Patients were received 4mg TA by single intravitreous injection or 40mg TA by three times sub-Tenoninfusion at 0d, 2w, 4w. The best corrected visual acuity, fundus examination, intraocular pressure, fundus fluorescence angiography were further analyzed, and the retinal thickness of macular fovea were measured by OCT. Main Outcome Measures The visual acuity, thickness of retinal macular fovea, ocular pressure was measured. Results 32 cases (32 eyes) completed the 24 week followed-up. In group IVI, the visual acuity before and after injection was 0.10±0. 03, 0.24±0.06(F=15.459, P=0.000) respectively; and retinal thickness of macular fovea is(460.73±46.33)μm,(394.53±41.43)μm (F=25. 282, P=0.0000) respectively. But in group STi, the visual acuity before and after injection is 0.11±0.04, 0.18±0.07(F=6.989, P=0.000) accordingly; and retinal thickness of maculur fovea is (454.76±56.28)μm,(424.94±42.69)μm (F=5.145, P=0.000) respectively. There was obvious statistical significance between two methods at same time point(all P<0.05). The serious, irreversible complications had not been found in all patients during follow-up. Conclusion Triamcinolone acetonide by single intravitreous injection or repeatedly sub-Tenoninfasion are good ways to relieve diabetic macular oederna, IVA-TA is more effective, and STi-TA safer. (Ophthaimol CHN, 2009, 18: 246-250)
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PURPOSE: To evaluate the effectiveness of intravitreous injection of Vancomycin and Amikacin in exogenous endophthalmitis (before culture results are obtained), and the relationship between such empirical therapy and results of culture, susceptibilities of cultured organism to antibiotics, and visual prognosis. METHODS: The authors conducted a retrospective study of 23 patients (23 eyes) who had been treated for endophthalmitis between May 1996 and November 2000. RESULTS: The final vision was 0.15 and better in 18 eyes out of 23 eyes, and 5 eyes reported vision worse than 0.1. Endophthalmitis was associated with cataract surgery in 15 eyes, ocular traumja in 7 eyes, filtration surgery in 1 eye. Eyes with posttraumatic endophthalmitis had worse visual prognosis. When smear and culture was performed, 14 out of 23 eyes were tested positive, and all the obtained microorganisms showed sensitivity to vancomycin and amikacin. The results were similar between Gram positive and negative bacteria. When the onset of symptoms was within 1 week after intraocular operation, and when the patients with ocular trauma reported to the hospital within two days, the prognosis was relatively better. The use of intravitreous antibiotics alone yielded similar results compared to the use of combined systemic antibiotics. Two out of 5 eyes which underwent vitrectomy and 16 out of 18 eyes which did not undergo vitrectomy reported final vision of 0.15 or better. CONCLUSIONS: When endophthalmitis is suspected, one should immediately perform diagnostic workup and the patient is immediately given intravitreous injection of vancomycin and amikacin. When smear and culture results are obtained later on, one can modify and improve the treatment modalities in an attempt to improve visual prognosis.