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| 題 名 | Intravitreous Recombinant Tissue Plasminogen Activator and Gas to Treat Submacular Hemorrhage in Age-Related Macular Degeneration=玻璃體內注射rTPA及氣體治療老年性黃斑部退化的黃斑部下出血 |
|---|---|
| 作 者 | 蔡三章; 林正明; 陳幸宜; | 書刊名 | The Kaohsiung Journal of Medical Sciences |
| 卷 期 | 19:12 2003.12[民92.12] |
| 頁 次 | 頁608-616 |
| 分類號 | 416.746 |
| 關鍵詞 | 黃斑部下出血; 老年性黃斑部退化; Recombinant tissue plasminogen activator; Submacular hemorrhage; Age-related macular degeneration; |
| 語 文 | 英文(English) |
| 中文摘要 | 本篇評估玻璃體內注射 rTPA 及氣體,用於治療老年性黃斑部退化引起的黃斑部下出血的安全性及效用。從 89 年 1 月到 91 年 4 月,我們共收集了因老年性黃斑部退化所引起的黃斑部下出血的 15 位病人,所有的病人均接受玻璃體內注射 100 μg rTPA 及 0.3 mL 的 C3F8。手術後病人先平躺 4 小時,之後維持趴睡姿勢 4 天。經過 6-19 個月的追蹤,我們評估出血吸收及視力恢復的情形。結果顯示,在 15 個病人中,出血完全位移的有 12 人,佔 80%;出血部分位移的有 3 人,佔 20%。術後最佳視力,全部病人均有改善,有 7 人 (47%) 改善大於 2 行。最終視力,有 12 人改善,有 2 人維持穩定及 1 人變壞。同時我們的結果也顯示出:出血期間 ≤ 21 天有較好的術後最佳視力的進步及最終視力的改善 (p = 0.0256 及 0.044)。在併發症方面,除了有 2 位病人在術後第一天產生輕微玻璃體出血外,其他沒有發現 rTPA 產生的視網膜毒性。玻璃體內注射 rTPA 及氣體對於老年性黃斑部退化引起的黃斑部下出血,視力方面改善是安全而且有效的。雖然最終的視力有時會受到自然疾病進展的影響,但是藉由這個方便簡單的方法,的確能使視力在一段長時間的追蹤下有明顯的改善與進步。 |
| 英文摘要 | We evaluated the safety and efficacy of intravitreous recombinant tissue plasminogen activator (rTPA) and gas for the treatment of submacular hemorrhage in age-related macular degeneration (ARMD). From January 2000 to April 2002, we enrolled 15 patients with submacular hemorrhage secondary to ARMD. All patients received 100 μg rTPA and 0.3 mL perfluoropropane intravitreously. Postoperatively, all patients were kept in a supine position for 4 hours followed by a face-down position for 4 days. Anatomic and functional results were evaluated during a follow-up period of 6 to 19 months. Submacular blood was completely displaced in 12 patients (80%) and partially in three (20%). Best postoperative visual acuity improved in all 15 eyes; in seven eyes (47%), the improvement was two or more lines. Final visual acuity improved in 12 eyes, remained stable in two eyes, and worsened in one eye. Onset of hemorrhage within 21 days was associated with better gains of lines in best postoperative (p = 0.0256) and final visual acuity (p = 0.044). Although two patients developed mild breakthrough vitreous hemorrhage within 1 day after treatment, no rTPA-related retinal toxicity was observed. Intravitreous injections of rTPA and gas are safe and effective in improving visual acuity in patients with submacular hemorrhage secondary to ARMD. Although the final visual outcome is often limited by the progression of the disease, significant and stable visual recovery over an extended follow-up period is possible using this easy and convenient technique. |
本系統中英文摘要資訊取自各篇刊載內容。