Association of intravitreal and topical anti-inflammatory therapies on short-term anatomical and functional outcomes following epiretinal membrane surgery

IF 2.8 3区医学 Q1 OPHTHALMOLOGY Acta Ophthalmologica Pub Date : 2024-12-20 DOI:10.1111/aos.17430

Pinja Sutinen, Idan Hecht, Minna Karesvuo, Sohee Jeon, Petteri Karesvuo, Raimo Tuuminen

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Abstract

Purpose

Here we examine the association of anti-inflammatory therapy with anatomical and functional outcomes of epiretinal membrane surgery.

Methods

The study included consecutive patients having gone through epiretinal membrane surgery at Helsinki University Hospital, Finland, between 2017 and 2021. The association of perioperative intravitreal and postoperative topical anti-inflammatory therapies with surgical outcomes was assessed.

Results

In total, 214 eyes of 214 patients with a mean age of 71.2 ± 8.2 years were studied. At 1-month, perioperative intravitreal use of triamcinolone acetonide (n = 27) was associated with a significant proportional and absolute improvement in foveal thickness (−15.9 ± 18.4% vs. −4.2 ± 25.6%, p = 0.003 and −86.2 ± 109.6 μm vs. −33.7 ± 94.3 μm, p = 0.004), and central subfield macular thickness (−14.7 ± 16.5% vs. −6.3 ± 16.9%, p = 0.009 and −80.6 ± 102.8 μm vs. −36.1 ± 75.9 μm, p = 0.004) when compared to those without triamcinolone acetonide. Furthermore, best-corrected visual acuity (BCVA) gain showed a non-significant yet corresponding trend favouring intraoperative intravitreal use of triamcinolone acetonide (0.21 ± 0.27 vs. 0.09 ± 0.28 LogMAR units, p = 0.062). Postoperative use of topical non-steroidal anti-inflammatory drugs (NSAIDs) (n = 36) as adjunct therapy showed no significant advantage in anatomical outcomes or BCVA gain when compared to those without NSAIDs (all p > 0.05). Triamcinolone acetonide remained significant for proportional and absolute improvement in foveal thickness (p = 0.019 and p = 0.006) and in central subfield macular thickness (p = 0.013 and p = 0.006) when controlled for confounding factors patient age and gender and topical NSAID use.

Conclusions

Intraoperative intravitreal use of triamcinolone acetonide improved short-term anatomical outcomes in patients who underwent epiretinal membrane surgery.

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玻璃体内和局部抗炎治疗对视网膜前膜手术后短期解剖和功能结果的影响。

目的：本文研究抗炎治疗与视网膜前膜手术解剖和功能结果的关系。方法：该研究纳入了2017年至2021年在芬兰赫尔辛基大学医院接受视网膜外膜手术的连续患者。评估围手术期玻璃体内和术后局部抗炎治疗与手术结果的关系。结果：214例患者214只眼，平均年龄71.2±8.2岁。月,在围手术期intravitreal使用去炎松醋酸酯(n = 27)与一个重要的比例和绝对改善视网膜中央凹厚度(-15.9±18.4%和-4.2±25.6%,p = 0.003和-86.2±109.6μm和-33.7±94.3μm, p = 0.004),和中央分区黄斑厚度(-14.7±16.5%和-6.3±16.9%,p = 0.009和-80.6±102.8μm和-36.1±75.9μm, p = 0.004)相比,那些没有去炎松醋酸酯。此外，最佳矫正视力（BCVA）增益显示术中玻璃体内使用曲安奈德（0.21±0.27比0.09±0.28 LogMAR单位，p = 0.062）的趋势不显著，但相应的趋势有利于曲安奈德。术后使用局部非甾体抗炎药（NSAIDs）（n = 36）作为辅助治疗，与未使用NSAIDs的患者相比，在解剖结果或BCVA增益方面没有显著优势（均p < 0.05）。在控制混杂因素患者年龄、性别和局部使用非甾体抗炎药的情况下，曲安奈德对中央窝厚度（p = 0.019和p = 0.006）和中央亚区黄斑厚度（p = 0.013和p = 0.006）的比例和绝对改善仍然显著。结论：术中玻璃体内使用曲安奈德可改善视网膜前膜手术患者的短期解剖结果。

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来源期刊

Acta Ophthalmologica 医学-眼科学

CiteScore

7.60

自引率

5.90%

发文量

433

审稿时长

6 months

期刊介绍： Acta Ophthalmologica is published on behalf of the Acta Ophthalmologica Scandinavica Foundation and is the official scientific publication of the following societies: The Danish Ophthalmological Society, The Finnish Ophthalmological Society, The Icelandic Ophthalmological Society, The Norwegian Ophthalmological Society and The Swedish Ophthalmological Society, and also the European Association for Vision and Eye Research (EVER). Acta Ophthalmologica publishes clinical and experimental original articles, reviews, editorials, educational photo essays (Diagnosis and Therapy in Ophthalmology), case reports and case series, letters to the editor and doctoral theses.