AI Summary & Key Takeaways
AI InsightConclusion: PSTT treatment is found effective to contain posterior segment inflammation of uveits.
📌 3 Key Takeaways
Abstract
Purpose: The purpose of this study is to investigate efficiency and complications of posterior subtenon triamcinolone (PSTT) injection for treatment of uveits. Materials and Methods: 40 eyes of 22 patients, which were diagnosed with uveit and treated with PSTT in our clinic, are included in this study. Before and after PSTT treatment visual acuity on 1st, 3rd and 6th months, complications such as vitritis, retinal vasculitis or changes in cystoid macular oedema (CMO), increase in intraocular pressure (IOP) and cataract progression were recorded. Success of treatment was evaluated with clinic and angiographic regression for CMO and vasculitis. Vitritis was followed with biomicroscobic examination. Wilcoxon test was used for statistical analysis. Results: 40 eyes of 22 patients were followed for average 18.2 months (6-21 months). Included patient in study; Grup A: Idiopathic, Grup B: Behçet, Grup C: Pars planit for üveitis. When results were examined, PSTT efficiency found; CMO was observed in 40% of the patients at the beginning and was observed 20% in the 1st month, 20% in the 3rd month and 10% in the 6th month, vitritis was observed in 100% of the patients at the beginning and was observed 10% in the 1st month, 10% in the 3rd month and 0% in the 6th month and vasculitis was observed in 10% of the patients at the beginning and was observed 0% in the 1st month for Group A. CMO was observed in 60% of the patients at the beginning and was observed 40% in the 1st month, 30% in the 3rd month and 30% in the 6th month, vitritis was observed in 90% of the patients at the beginning and was observed 40% in the 1st month, 0% in the 3rd month and vasculitis was observed in 10% of the patients at the beginning and was observed 10% in the 1st month and 0% in the 3rd month for Group B. CMO was observed in 50% of the patients at the beginning and was observed 0% in the 1st month and vitritis was observed in 100% of the patients at the beginning and was observed 0% in the 1st month, for Group C. The effect of PSTT treatment on visual acuity was; 0.36 at the beginning and 0.48, 0.50, 0.49 at the 1st 3rd and 6th months respectively for Group A, 0.53 at the beginning and 0.60, 0.56, 0.56 at the 1st 3rd and 6th months respectively for Group B and 0.40 at the beginning and 0.48, 0.49, 0.49 at the 1st 3rd and 6th months respectively for Group C. During the follow-up period intraocular pressure was observed over 21mmHg on 2 eyes (5%). With topical antiglaucoma treatment, IOP was taken under control. On 3 eyes (7.5%) cataract progression was observed. Conclusion: PSTT treatment is found effective to contain posterior segment inflammation of uveits.
Özet
Amaç: Üveitlerin tedavisinde posterior subtenon triamsinolon (PSTT) enjeksiyonunun etkinliği ve komplikasyonlarını araştırmak. Gereç ve Yöntem: Kliniğimizde üveit tanısıyla PSTT enjeksiyonu yapılan 22 hastanın 40 gözü çalışmaya alındı. Hastalarda PSTT tedavisi öncesi ve sonrası 1., 3. ve 6. aylardaki görme keskinliği, vitritis, retinal vaskülit veya kistoid maküler ödem (KMÖ)’deki değişiklikler, göz içi basıncı (GİB) artışı ve katarakt progresyonu gibi komplikasyonlar kaydedildi. Tedavi başarısı KMÖ ve vaskülit için klinik ile birlikte anjiyografik gerilemeyle değerlendirildi. Vitritis biyomikroskobik muayene ile takip edildi. İstatistiksel analizlerde Wilcoxon test kullanıldı. Bulgular: Toplam 22 hastanın 40 gözü ortalama 18.2 ay (6-21 ay) takip edildi. Çalışmaya alınanlardan Grup A: İdiopatik (10 hasta) Grup B: Behçete bağlı (10 hasta), Grup C: Pars planite bağlı (2 hasta) üveitti. Bulgular incelendiğinde PSTT etkinliği; Grup A’da KMÖ başlangıçta hastaların %40’ında görülürken, 1. ayda %20’sinde, 3. ayda %20’sinde, 6. ayda %10’unda saptandı, vitritis başlangıçta hastaların %100’ünde görülürken, 1. ayda %10’unda, 3. ayda %10’unda, 6. ayda hiçbir hastada saptanmadı, vaskülit başlangıçta hastaların %10’unda görülürken, 1. ayın sonunda saptanmadı, Grup B’de KMÖ başlangıçta hastaların %60’ında görülürken, 1. ayda %40’ında, 3. ayda %30’unda, 6. ayda %30’unda saptandı, vitritis başlangıçta hastaların %90’ında görülürken, 1. ayda %40’ında görüldü, 3. ve 6. ayda hiç birinde saptanmadı, vaskülit başlangıçta hastaların %10’unda görülürken, 3. ayın sonunda saptanmadı, Grup C’de KMÖ başlangıçta hastaların %50’sinde, vitritis %100’ünde görülürken, 1. ayın sonunda her iki bulgu da saptanmadı. PSTT tedavisinin görme keskinlikleri üzerine etkisi; Grup A’da başlangıçta 0.36’iken, 1. ayda 0.48, 3. ayda 0.50, 6. ayda 0.49’idi. Grup B’de başlangıçta 0.53’iken, 1. ayda 0.60, 3. ayda 0.56, 6. ayda 0.56 olarak saptandı. Grup C’de başlangıçta 0.40’iken, 1. ayda 0.48, 3. ayda 0.49, 6. ayda 0.49 olarak saptandı. Takip süresince 2 gözde (%5) GİB 21mmHg’nın üzerinde saptandı. Topikal anti-glokomatöz tedavi ile GİB kontrol altına alındı. Gözlerin 3’ünde (%7.5) katarakt progresyonu gözlendi. Sonuç: PSTT tedavisinin üveitlerde arka segment inflamasyonunun kontrol edilmesinde etkin olduğu saptandı.