许迅
上海交通大学第一人民医院 200080
眼部的局部给药方式影响着药物作用的强度，速率及持续时间和不良反应。视网膜，脉络膜，玻璃体及视神经的疾病则对眼后节的局部给药治疗提出了挑战，以局部给药的方式通过解剖学的膜屏障及泪液排泄，并达到在特定部位起治疗作用的药物浓度是其中的重要课题。全身给药则难以在眼组织积蓄足够的药物浓度，且易引起全身性的不良反应。眼表局部应用滴眼剂在泪液循环及角膜，结膜的屏障作用下易发生流失，而有创的给药方式包括玻璃体内注射，结膜下注射等变得越来越普遍的同时，除对病人造成疼痛不适外，甚至也可导致多种严重于疾病本身的并发症。因此，选择合适的药物通过安全的途径进入眼内达到有效作用，将是眼科工作者努力的目标。
S-027 Intravitreal Triamcinolone after Intravitreal Bevacizumab for Retinal Vein Occlusions
Jost B.Jonas Teodosio Libondi Frank Schlichtenbrede Matthias Schmidbauer
Department of Ophthalmology，Medical Faculty Mannheim of the Ruprecht-Karls-University Heidelberg，Germany Department of Ophthalmology，II.University of Naples，Italy 100005
Purpose:To assess the effect of intravitreal triamcinolone acetonide on macular edema and visual acuity after previously unsuccessful intravitreal bevacizumab for treatment of retinal vein occlusions。
Method:The study included patients with retinal vein occlusions who had previously received an intravitreal injections of bevacizumab without an increase in visual acuity nor decrease in macular edema.The patients received a single intravitreal injection of about 25 mg triamcinolone。
Results:The study consisted of 2 patients(2 eyes)with an age of 64 years and 63 years.The mean visual acuity prior to the injection of bevacizumab was 0.03 and 0.10，respectively.After a follow-up of 3 to 10 months after the triamcinolone injection，the visual acuity improved to 0.10 and 0.20，respectively.Macular thickness markedly decreased from 431 μm to 175 μm，and from 453 μm to 246 μm，respectively。
Conclusions:Intravitreal triamcinolone may improve vision and reduce macular edema in patients with retinal vein occlusions if previously administered intravitreal bevacizumab failed to increase visual acuity and reduce macular edema. |
