Lijun Shen1, Jianbo Mao1, Shumao Sun2, Yugui Dong1, Yiqi Chen1, Lingyun Cheng2,3. 1. Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China. 2. Institute of Ocular Pharmacology, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China. 3. Department of Ophthalmology, Jacob's Retina Center at Shiley Eye Center, University of California, San Diego, La Jolla, California, USA.
Abstract
PURPOSE: To compare subtenon triamcinolone versus systemic dexamethasone for perisurgical management of primary rhegmatogenous retinal detachment presenting with a choroidal detachment (RRD/CD). METHODS: Thirty consecutive primary RRD/CD patients were prospectively studied. Sixteen RRD/CD patients were injected with a 40 mg subtenon triamcinolone acetonide (TA) 5 days before a scheduled vitrectomy (TA group) while the other 14 RRD/CD patients were intravenously infused daily with 10 mg dexamethasone (Dex) for 5 days before a scheduled vitrectomy (Dex group). All patients were followed up for 6 months. Changes of choroid detachment on B ultrasonography and preoperative intraocular pressure (IOP), systemic and ocular steroid level, blood sugar, and postoperative macular oedema were compared between the two groups. RESULTS: During 5 days of presurgical treatment, the IOP recovery from the baseline was 3.29 ± 4.56 mmHg for the TA group versus 1.16 ± 1.60 mmHg for the Dex group (p = 0.021). The height of CD decreased significantly more for the TA group (3.55 ± 1.33 versus 1.84 ± 1.5 mm, p = 0.0029). The physiological cortisol level in the plasma was significantly suppressed for the Dex group (8.35 ± 10.35 versus 51.9 ± 35.9 ng/ml, p = 0.01). Postoperative 1-month macula was less oedematous for TA group (401 ± 196 versus 256 ± 66 μm, p = 0.0498). CONCLUSION: Subtenon TA seems to be a better option for perisurgical management of RRD/CD patients than systemic steroid application. Subtenon TA is more convenient for patients and imposes much less stress to patients' hormones homeostasis. This is especially important for those who are suffering metabolic disorders and need vitrectomy surgery for repairing RRD/CD.
PURPOSE: To compare subtenon triamcinolone versus systemic dexamethasone for perisurgical management of primary rhegmatogenous retinal detachment presenting with a choroidal detachment (RRD/CD). METHODS: Thirty consecutive primary RRD/CDpatients were prospectively studied. Sixteen RRD/CDpatients were injected with a 40 mg subtenon triamcinolone acetonide (TA) 5 days before a scheduled vitrectomy (TA group) while the other 14 RRD/CDpatients were intravenously infused daily with 10 mg dexamethasone (Dex) for 5 days before a scheduled vitrectomy (Dex group). All patients were followed up for 6 months. Changes of choroid detachment on B ultrasonography and preoperative intraocular pressure (IOP), systemic and ocular steroid level, blood sugar, and postoperative macular oedema were compared between the two groups. RESULTS: During 5 days of presurgical treatment, the IOP recovery from the baseline was 3.29 ± 4.56 mmHg for the TA group versus 1.16 ± 1.60 mmHg for the Dex group (p = 0.021). The height of CD decreased significantly more for the TA group (3.55 ± 1.33 versus 1.84 ± 1.5 mm, p = 0.0029). The physiological cortisol level in the plasma was significantly suppressed for the Dex group (8.35 ± 10.35 versus 51.9 ± 35.9 ng/ml, p = 0.01). Postoperative 1-month macula was less oedematous for TA group (401 ± 196 versus 256 ± 66 μm, p = 0.0498). CONCLUSION: Subtenon TA seems to be a better option for perisurgical management of RRD/CDpatients than systemic steroid application. Subtenon TA is more convenient for patients and imposes much less stress to patients' hormones homeostasis. This is especially important for those who are suffering metabolic disorders and need vitrectomy surgery for repairing RRD/CD.
Authors: Vincenza Bonfiglio; Michele Reibaldi; Iacopo Macchi; Matteo Fallico; Corrado Pizzo; Clara Patane; Andrea Russo; Antonio Longo; Alessandra Pizzo; Giovanni Cillino; Salvatore Cillino; Maria Vadalà; Michele Rinaldi; Robert Rejdak; Katarzyna Nowomiejska; Mario Damiano Toro; Teresio Avitabile; Elina Ortisi Journal: J Clin Med Date: 2020-05-21 Impact factor: 4.241