HJO  >> Vol. 4 No. 3 (September 2015)

    Injection of Triamcinolone Acetonide (TA) under Tenon’s on the Macular Serous Retinal Detachment of Vogt-Koyanagi-Harada (VKH) Disease

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肖 静,高付林,郭惠玲:解放军306医院眼科,北京

Vogt-小柳-原田氏病曲安奈德Tenon’s囊Vogt-Koyanagi-Harada Disease Triamcinolone Acetonide Tenon’s Capsure


目的:观察曲安奈德球后Tenon囊下注射联合全身糖皮质激素治疗Vogt-小柳-原田氏病的临床疗效。方法:经眼底荧光血管造影和频域OCT确诊的Vogt-小柳-原田氏病18例34眼,病变急性期给予行大剂量糖皮质激素冲击治疗,激素减量期间结合曲安奈德后Tenon囊下注射,时间为每月1次,20 mg/0.5 ml次,共3次。所有患者在治疗前及治疗后检查裸眼视力、最佳矫正视力、眼前节检查、眼底彩照和频域光相干断层扫描,并使用SPSS17.0 对数据进行统计学分析。结果:治疗后所有患者视力均有不同程度提高。治疗前所有患者造影出现多数针尖状高荧光点和多湖状高荧光斑,治疗6个月,32眼荧光素眼底血管造影未见异常,其平均高度为378 ± 234 um。治疗后其平均高度为153 ± 67 um,比治疗前平均下降59.5%。两组比较差异有显著统计学意义(p < 0.01)。结论:曲安奈德后Tenon’s注射治疗Vogt-小柳-原田病,能够明显改善黄斑区的浆液性视网膜脱离并能减少疾病的复发。

Objectives: To observe the clinic effect of Vogt-Koyanagi- Harada (VKH) Disease by injecting triamcinolone acetonide (TA) under Tenon’s. Methods: 34 eyes of 18 consecutive patients diagnosed with acute Vogt-Koyanagi-Harada Disease by FFA and OCT. All the patients were given pmethylprednisolone combined with triamcinolone acetonide (TA) injection under Tenon’s, and the frequency is once a month, 20 mg/0.5ml every time, and it will be done totally three times. All the patients were performed no-corrected visual activity, best corrected visual activity, slit- lamp check, fundus photograph and spectral-domain optical coherence tomography (OCT) at the initial visit and 6 months after steroid treatment. All the data were analyzed by SPSS 17.0. Results: After the treatment, all the patients’ VA improved. At the initial, all eyes showed the most hyperfluorescence pinpoints and the leakage of fluorescence pooling. After treatment for 6 months, the FFA of 32 patients showed normal. The thickness of fovea was (378 ± 234) μm before treatment and (153 ± 67) μm after treatment, which decreased by 59.5% on average; there was significantly difference between the two groups (p < 0.01). Conclusion: For VHK disease, the treatment of pmethylprednisolone combined with TA injection under Tenon’s can improve the macular serous retinal detachment and reduce the relapse of the disease.

肖静, 高付林, 郭惠玲. 曲安奈德后Tenon囊下注射治疗Vogt-小柳-原田氏病黄斑部浆液性脱离[J]. 眼科学, 2015, 4(3): 47-51. http://dx.doi.org/10.12677/HJO.2015.43009


[1] Read, R., Yu, F., Accorinti, M., Bodaghi, B., Chee, S.-P., Fardeau, C., et al. (2006) Evaluation of the effect on outcomes of the route of administration of corticosteroids in acute Vogt-Koyanagi-Harada disease. American Journal of Ophthalmology, 142,119-124.
[2] 杨培增 (2004) 临床葡萄膜炎. 人民卫生出版社, 北京, 293.
[3] Rao, N.A., Sukavatchsrin, S. and Tsai, J.H. (2007) Vogt-Koyanagi-Harada disease diagnostic criteria. International Ophthalmology, 27, 195-199.
[4] Durrani, O.M., Meads, C.A. and Murray, P.I. (2004) Uveitis: A potentially blinding disease. Ophthalmologica, 218, 223-236.
[5] Martidis, A., Duker, J.S., Greenbery, P.B., Rogers, A.H., Puliafito, C.A., Reichel, E. and Baumal, C. (2002) Intravitreal triamcinolone forefractory diabetic macular edema. Ophthalmology, 109, 920-927.
[6] Andrade, R., Muccioli, C. and Farah, M. (2004) Intravi-treal triamcinolone acetonide injection in the treatment of Vogt- Koyanagi-Harada syndrome. Arquivos Brasileiros de Oftalmologia, 67, 401-406.
[7] Couch, S.M. and Bakri, S.J. (2009) Intravitreal triam-cinolone for intraocular inflammation and associated macular edema. Clinical Ophthalmology, 3, 41-47.
[8] Perente, I., Utice, C.A., Cakir, H., Kaya, V., Tutkun, I.T. and Yilmaz, O.F. (2009) Management of ocular complications of Vogt-Koyanagi-Harada syndrome. International Ophthalmology, 29, 33-37.
[9] 关红英, 李双农 (2009) 后Tenon囊下注射曲安奈德后玻璃体腔内药物质量浓度的测定. 眼科研究, 6, 507-510.