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      반복된 유리체강내 베바시주맙 주입술 후 재발한 당뇨황반부종에 후테논낭하 트리암시놀론 주입술 = Posterior Sub-Tenon Triamcinolone Acetonide Injection for Recurrent Diabetic Macular Edema after Repeated Intravitreal Bevacizumab Injections

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      https://www.riss.kr/link?id=A100524117

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      다국어 초록 (Multilingual Abstract)

      Purpose: To evaluate posterior sub-Tenon injection of triamcinolone acetonide (TA) for recurrent diabetic macular edema (DME) after repeated intravitreal bevacizumab (IVB). Methods: This is a retrospective interventional case series comprised of 35 eyes (32 patients) with recurrent clinically significant DME after two or more IVB treatments. All patients were administered TA 40 mg injections. Best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) were reevaluated at months 1, 3, and 6. Results: The baseline OCT showed five eyes with diffuse retinal thickening, 18 eyes with cystoid macular edema, and 12 eyes with serous retinal detachment. Mean BCVA improved at months 1 and 3, and mean CMT decreased at months 1 and 3. However, mean BCVA and CMT at six months was not different from baseline. Each DME pattern showed significant improvements in BCVA and CMT at three months. Mean IOP at months 1, 3, and 6 did not show any significant difference from baseline. No eyes showed complications including cataract progression or endophthalmitis. Conclusions: Posterior sub-Tenon injection of TA should be considered for patients with recurrent DME after repeated IVB. The studied eyes showed improvements in BCVA and CMT during three months in all of the three patterns of DME. J Korean Ophthalmol Soc 2011;52(9):1063-1070
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      Purpose: To evaluate posterior sub-Tenon injection of triamcinolone acetonide (TA) for recurrent diabetic macular edema (DME) after repeated intravitreal bevacizumab (IVB). Methods: This is a retrospective interventional case series comprised of 35 ey...

      Purpose: To evaluate posterior sub-Tenon injection of triamcinolone acetonide (TA) for recurrent diabetic macular edema (DME) after repeated intravitreal bevacizumab (IVB). Methods: This is a retrospective interventional case series comprised of 35 eyes (32 patients) with recurrent clinically significant DME after two or more IVB treatments. All patients were administered TA 40 mg injections. Best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) were reevaluated at months 1, 3, and 6. Results: The baseline OCT showed five eyes with diffuse retinal thickening, 18 eyes with cystoid macular edema, and 12 eyes with serous retinal detachment. Mean BCVA improved at months 1 and 3, and mean CMT decreased at months 1 and 3. However, mean BCVA and CMT at six months was not different from baseline. Each DME pattern showed significant improvements in BCVA and CMT at three months. Mean IOP at months 1, 3, and 6 did not show any significant difference from baseline. No eyes showed complications including cataract progression or endophthalmitis. Conclusions: Posterior sub-Tenon injection of TA should be considered for patients with recurrent DME after repeated IVB. The studied eyes showed improvements in BCVA and CMT during three months in all of the three patterns of DME. J Korean Ophthalmol Soc 2011;52(9):1063-1070

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      참고문헌 (Reference)

      1 송현재, "증식당뇨망막병증 환자에서 유리체내 베바시주맙 주입술 후 발생한 견인망막박리" 대한안과학회 50 (50): 1751-1754, 2009

      2 손희진, "유리체강내 트리암시놀론 주사 후 발생한 감연성 안내염 1 예" 대한안과학회 47 (47): 1865-1870, 2006

      3 오세범, "당뇨황반부종의 치료에서 유리체강내 트리암시놀론과 베바시주맙 주입술의 효과 비교" 대한안과학회 50 (50): 1190-1196, 2009

      4 김영균, "당뇨황반부종의 종류에 따른 트리암시놀론 안내주입술의 임상분석" 대한안과학회 46 (46): 13-13, 2005

      5 윤상철, "당뇨황반부종의 빛간섭단층촬영 분류에 따른 트리암시놀론 안내주입술의 효과" 대한안과학회 49 (49): 1611-1618, 2008

      6 김훈동, "당뇨황반부종에서 유리체내 베바시주맙 및 후테논낭하 스테로이드 주입술 병합요법의 효과" 대한안과학회 50 (50): 1652-1656, 2009

      7 Funatsu H, "Vitreous levels of vascular endothelial growth factor and intercellular adhesion molecule 1 are related to diabetic macular edema" 112 : 806-816, 2005

      8 Funatsu H, "Vitreous levels of interleukin- 6 and vascular endothelial growth factor are related to diabetic macular edema" 110 : 1690-1696, 2003

      9 Inoue M, "Vitreous concentrations of triamcinolone acetonide in human eyes after intravitreal or subtenon injection" 138 : 1046-1048, 2004

      10 Nguyen QD, "Vascular endothelial growth factor is a critical stimulus for diabetic macular edema" 142 : 961-969, 2006

      1 송현재, "증식당뇨망막병증 환자에서 유리체내 베바시주맙 주입술 후 발생한 견인망막박리" 대한안과학회 50 (50): 1751-1754, 2009

      2 손희진, "유리체강내 트리암시놀론 주사 후 발생한 감연성 안내염 1 예" 대한안과학회 47 (47): 1865-1870, 2006

      3 오세범, "당뇨황반부종의 치료에서 유리체강내 트리암시놀론과 베바시주맙 주입술의 효과 비교" 대한안과학회 50 (50): 1190-1196, 2009

      4 김영균, "당뇨황반부종의 종류에 따른 트리암시놀론 안내주입술의 임상분석" 대한안과학회 46 (46): 13-13, 2005

      5 윤상철, "당뇨황반부종의 빛간섭단층촬영 분류에 따른 트리암시놀론 안내주입술의 효과" 대한안과학회 49 (49): 1611-1618, 2008

      6 김훈동, "당뇨황반부종에서 유리체내 베바시주맙 및 후테논낭하 스테로이드 주입술 병합요법의 효과" 대한안과학회 50 (50): 1652-1656, 2009

      7 Funatsu H, "Vitreous levels of vascular endothelial growth factor and intercellular adhesion molecule 1 are related to diabetic macular edema" 112 : 806-816, 2005

      8 Funatsu H, "Vitreous levels of interleukin- 6 and vascular endothelial growth factor are related to diabetic macular edema" 110 : 1690-1696, 2003

      9 Inoue M, "Vitreous concentrations of triamcinolone acetonide in human eyes after intravitreal or subtenon injection" 138 : 1046-1048, 2004

      10 Nguyen QD, "Vascular endothelial growth factor is a critical stimulus for diabetic macular edema" 142 : 961-969, 2006

      11 Wilson CA, "Treatment with intravitreal steroid reduces blood-retinal barrier breakdown due to retinal photocoagulation" 110 : 1155-1159, 1992

      12 Beck RW, "Three-year follow-up of a randomized trial comparing focal/grid photocoagulation and intravitreal triamcinolone for diabetic macular edema" 127 : 245-251, 2009

      13 Bhavsar AR, "The risk of endophthalmitis following intravitreal triamcinolone injection in the DRCRnet and SCORE clinical trials" 144 : 454-456, 2007

      14 Aiello LP, "The potential role of PKC beta in diabetic retinopathy and macular edema" 47 (47): 263-269, 2002

      15 Umland SP, "The inhibitory effects of topically active glucocorticoids on IL-4, IL-5, and interferon- gamma production by cultured primary CD4+ T cells" 100 : 511-519, 1997

      16 Kang SW, "The correlation between fluorescein angiographic and optical coherence tomographic features in clinically significant diabetic macular edema" 137 : 313-322, 2004

      17 Chylack LT Jr, "The Lens Opacities Classification System III. The Longitudinal Study of Cataract Study Group" 111 : 831-836, 1993

      18 Roh MI, "Repeated intravitreal injection of bevacizumab for clinically significant diabetic macular edema" 28 (28): 1314-1318, 2008

      19 Arevalo JF, "Primary intravitreal bevacizumab for diffuse diabetic macular edema: the Pan-American Collaborative Retina Study Group at 24 months" 116 : 1488-1497, 2009

      20 Arevalo JF, "Primary intravitreal bevacizumab (Avastin) for diabetic macular edema: results from the Pan-American Collaborative Retina Study Group at 6-month follow-up" 114 : 743-750, 2007

      21 Stewart MW, "Predicted biologic activity of intravitreal bevacizumab" 27 : 1196-1200, 2007

      22 Early Treatment Diabetic Retinopathy Study Research Group, "Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1" 103 : 1796-1806, 1985

      23 Bakri SJ, "Pharmacokinetics of intravitreal bevacizumab (Avastin)" 114 : 855-859, 2007

      24 Audren F, "Pharmacokinetic-pharmacodynamic modeling of the effect of triamcinolone acetonide on central macular thickness in patients with diabetic macular edema" 45 : 3435-3441, 2004

      25 Ikewaki J, "Peribulbar fungal abscess and endophthalmitis following posterior subtenon injection of triamcinolone acetonide" 87 : 102-104, 2009

      26 Otani T, "Patterns of diabetic macular edema with optical coherence tomography" 127 : 688-693, 1999

      27 Kim BY, "Optical coherence tomographic patterns of diabetic macular edema" 142 : 405-412, 2006

      28 Kim NR, "Optical coherence tomographic patterns in diabetic macular oedema: prediction of visual outcome after focal laser photocoagulation" BRITISH MED JOURNAL PUBL GROUP 93 : 901-905, 2009

      29 Lee CM, "Modified grid laser photocoagulation for diffuse diabetic macular edema. Long-term visual results" 98 : 1594-1602, 1991

      30 Floman N, "Mechanism of steroid action in ocular inflammation: Inhibition of prostaglandin production" 16 : 69-73, 1977

      31 Kent D, "Macular oedema: the role of soluble mediators" 84 : 542-545, 2000

      32 Kook D, "Long-term effect of intravitreal bevacizumab (avastin) in patients with chronic diffuse diabetic macular edema" 28 : 1053-1060, 2008

      33 Biester S, "Is intravitreal bevacizumab treatment effective in diffuse diabetic macular edema" 247 : 1575-1577, 2009

      34 Cellini M, "Intravitreal vs. subtenon triamcinolone acetonide for the treatment of diabetic cystoid macular edema" 8 : 5-12, 2008

      35 Gillies MC, "Intravitreal triamcinolonefor refractory diabetic macular edema: two-year results of a double-masked, placebo-controlled, randomized clinical trial" 113 : 1533-1538, 2006

      36 Paccola L, "Intravitreal triamcinolone versus bevacizumab for treatment of refractory diabetic macular oedema" 92 : 76-80, 2008

      37 Smithen LM, "Intravitreal triamcinolone acetonide and intraocular pressure" 138 : 740-743, 2004

      38 Bonini-Filho MA, "Intravitreal injection versus sub-Tenon's infusion of triamcinolone acetonide for refractory diabetic macular edema: a randomized clinical trial" 46 : 3845-3849, 2005

      39 Jonas JB, "Intraocular pressure after intravitreal of triamcinolone acetonide" 87 : 24-27, 2003

      40 Kang BS, "Inhibitory effects of anti-inflammatory drugs on interleukin-6 bioactivity" 24 : 701-703, 2001

      41 Artunay O, "Incidence and management of acute endophthalmitis after intravitreal bevacizumab (Avastin) injection" 23 : 2187-2193, 2009

      42 Fischer S, "In vitro effects of dexamethasone on hypoxia-induced hyperpermeability and expression of vascular endothelial growth factor" 411 : 231-243, 2001

      43 Ozdek S, "Hasanreisoglu B. Posterior subtenon and intravitreal triamcinolone acetonide for diabetic macular edema" 20 : 246-251, 2006

      44 Tong JP, "Effects of triamcinolone on the expression of VEGF and PEDF in human retinal pigment epithelial and human umbilical vein endothelial cells" 12 : 1490-1495, 2006

      45 Chung EJ, "Effects of macular ischemia on the outcome of intravitreal bevacizumab therapy for diabetic macular edema" 28 (28): 957-963, 2008

      46 Sander B, "Diabetic macular edema: passive and active transport of fluorescein through the blood-retina barrier" 42 : 433-438, 2001

      47 Shima C, "Complications in patients after ntravitreal injection of bevacizumab" 86 : 372-376, 2008

      48 Isaac DL, "Comparing intravitreal triamcinolone acetonide and bevacizumab injections for the treatment of diabetic macular oedema: a randomized double-blind study" 16 : 2009

      49 Shimura M, "Comparative therapy evaluation of intravitreal bevacizumab and triamcinolone acetonide on persistent diffuse diabetic macular edema" 145 : 854-861, 2008

      50 Bandi N, "Budesonide reduces vascular endothelial growth factor secretion and expression in airway (Calu-1) and alveolar (A549) epithelial cells" 425 : 109-116, 2001

      51 Chen E, "Acute visual acuity loss following intravitreal bevacizumab for diabetic macular edema" 40 : 68-70, 2009

      52 Huang ZL, "Acute vision loss after intravitrealinjection of bevacizumab (Avastin) associated with ocular ischemic syndrome" 224 : 86-89, 2009

      53 Moshfeghi DM, "Acute endophthalmitis following intravitreal triamcinolone acetonide injection" 136 : 791-796, 2003

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