RESUMEN
PURPOSE: To compare the efficacy and safety of subtenon triamcinolone acetonide (TA) injection with topical nepafenac 0.1% for the treatment of pseudophakic cystoid macular edema (CME). METHODS: In this prospective study, the TA group comprised 24 eyes and the nepafenac group 24 eyes. Best-corrected visual acuity (BCVA), central retinal thickness (CRT), intraocular pressure measurements, and slit-lamp fundoscopy were performed in all subjects at baseline, 1, 2, 3, and 6 months. RESULTS: Changes in BCVA and CRT over four follow-up visits were statistically significant (p<0.001). The mean CRT decreased from 513.3 to 318.9 µm in the TA group and from 483.7 to 278.0 µm in the nepafenac group. This reduction was statistically significant (p<0.001 for both groups). CONCLUSIONS: Our visual and OCT results suggest that both treatment modalities are effective with few side-effects. However, nepafenac is more efficacious than subtenon TA in terms of visual gain and its correlation with the reduction in CRT.
Asunto(s)
Antiinflamatorios no Esteroideos/administración & dosificación , Bencenoacetamidas/administración & dosificación , Glucocorticoides/administración & dosificación , Edema Macular/tratamiento farmacológico , Fenilacetatos/administración & dosificación , Seudofaquia/tratamiento farmacológico , Cápsula de Tenon/efectos de los fármacos , Triamcinolona Acetonida/administración & dosificación , Administración Oftálmica , Anciano , Anciano de 80 o más Años , Femenino , Angiografía con Fluoresceína , Humanos , Inyecciones Intraoculares , Edema Macular/fisiopatología , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Seudofaquia/fisiopatología , Retina/efectos de los fármacos , Retina/patología , Tomografía de Coherencia Óptica , Resultado del Tratamiento , Agudeza Visual/fisiologíaRESUMEN
PURPOSE: To evaluate retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness by using optical coherence tomography in unilateral exfoliation syndrome (XFS) and to assess whether exfoliation itself is an independent risk factor for glaucomatous optic nerve damage. MATERIALS AND METHODS: Thirty exfoliative eyes of unilateral XFS cases, 30 fellow eyes of unilateral exfoliation, and 30 eyes of healthy subjects were enrolled the study. Peripapillary RNFL and macular GCC thickness measurements by Cirrus HD OCT (Carl Zeiss Meditec, Dublin, CA) were performed on all subjects. RESULTS: RNFL thickness in superior quadrant was significantly different between groups (P=0.025) and it was thinner in XFS than healthy subjects (P=0.020). All GCC parameters except GCC thickness in inferior quadrant were significantly different between groups (P=0.110 for inferior quadrant, P<0.046 for other GCC parameters). GCC were thinner in XFS than healthy subjects except inferior and inferonasal quadrants (P=0.091, 0.051 for inferior and inferonasal quadrants, respectively, P<0.039 for other GCC parameters). Minimum GCC thickness, GCC thicknesses in superior, and inferonasal quadrants were significantly thinner in fellow eyes than healthy subjects (P=0.011, 0.013, 0.047, respectively). CONCLUSIONS: XFS is related with thinner RNFL and GCC even in normal intraocular pressure values, similar optic disc parameters and visual field results. XFS may be an independent risk factor for glaucomatous optic nerve damage. So, further studies are needed to evaluate whether exfoliation itself is an independent risk factor for optic nerve damage.