Clinical Efficacy Observation Of Intravitreal Injection And Posterior Subtenon Capsule Injection To Non-infectious Posterior Uveitis

Objective:In this clinical trail we will compare the effective and risk factors of three different treatment methods for posterior uveitis and evaluate a proper method for different kinds of uveitis. Methods :67 patients?75 eyes?were contained in this trail,they will be divided into three different groups and each group includes 25 eyes.Group A is intravitreal injection group which include 22?25eyes? patients,group B is posterior Tenon capsule injection which include 22?25eyes? patients and group C is oral group which include 23?25eyes?patients.There are 13 eyes with macular edema in group A, group B 12 andgroup C 11.The data of the best corrected visual acute?BCVA?,intra-ocular pressure?IOP?, macular region choroid thickness?MCT? and epimacular membrane will be collected before and after the treatment, which includes 1st week,1st month and 3rd month after the treatment. Statistical analysis will be made on the data such as BCVA and MCT. Results: Totally 67?75eyes?patients aging from 20 to 61?mean 38? years old,36 eyes of macular edema. 74?98.67%?eyes' best corrected visual acute improved apparently and thickness of macular edema loss obviously at the 3rd month, no macular edema was detected. The BCVA of group A before treatment was 1.31±0.43 log MAR,MCT was 454.91±46.60 um,mean improvement of BCVA at the 1st week was0.66±0.24 log MAR,MCT 94.47±50.76 um,12 eyes?91.67%?macular edema were cured. Mean improvement of BCVA at the 1st month was 0.94 ±0.32 log MAR,MCT 171.81±60.83 um,all of the macular edema were cured,mean improvement of BCVA at the 3rd month was 1.11±0.35 log MAR,MCT186.19 ± 51.99 um. In group B,the BCVA before treatment was 0.96 ±0.56 log MAR,MCT 408.33±62.25 um, mean improvement of BCVA at the1 st week was 0.37±0.26 log MAR,MCT 65.75±51.37 um,9 eyes?75%?macular edema were cured, mean improvement of BCVA at the 1st month was0.66 ± 0.45 log MAR,MCT126.49 ± 74.23 um,mean improvement of BCVA at the 3rd month was 0.78±0.49 log MAR,MCT 145.14±61.691 um,high IOP happened in 2 eyes but controlled with one kind of drop. In group C,the BCVA before treatment was 0.86±0.44 log MAR,MCT 417.56±80.90 um,mean improvement of BCVA at the 1st week was 0.25±0.19 log MAR,MCT46.08±28.15 um,5 eyes? 45.45%? macular edema were cured,mean improvement of BCVA at the 1st month was 0.48 ± 0.24 log MAR,MCT102.56±46.04 um,9 eyes? 81.81%? macular edema were cured, mean improvement of BCVA at the 3rd month was 0.72±0.33 log MAR,MCT155.41±58.72 um,no high IOP was detected but epimacular membrane was detected and no improvement of BCVA happened in one eye. Three groups clinical result of macular edema at the end of the first week was analysed by R×C table chi-square test,the result was ?²_0.05,2=5.99,p<0.05. We compare the best corrected visual acuity and MCT of the 1st week,1st month and 3rdmonth with one-way analysis of variance.Group A is the best,Group B is the second and Group C is the third. Conclusion: The treatment of intravitreal injection and posterior Tenon capsule injection can alleviate the macular edema andimprove BCVA quickly and patients satisfied a lot but it has the risk of recurrence and intraocular pressure elevation. These methods are appropriate to the patients who have no contraindication.Oral corticosteroids has a slow effecacy on uveitis but it will not cause intraocular pressure elevation and no recurrence in the long run, sometime epimacular membrane would occur but rarely. Intravitreal injection is the fastest way to cure macular edema, posterior Tenon capsule injection is the second and Oral corticosteroids is the slowest in this trail. These shows obviously differences among the three groups,intravitreal injection is the best way to improve BCVA and loss MCT.