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玻璃体内注射促红细胞生成素治疗慢性进行性糖尿病性黄斑水肿对患者的影响。

Effects of intravitreal erythropoietin therapy for patients with chronic and progressive diabetic macular edema.

作者信息

Li Weiye, Sinclair Stephen H, Xu Guo-Tong

机构信息

Department of Ophthalmology, Drexel University College of Medicine, 219 N. Broad Street, Philadelphia, PA 19107, USA.

出版信息

Ophthalmic Surg Lasers Imaging. 2010 Jan-Feb;41(1):18-25. doi: 10.3928/15428877-20091230-03.

Abstract

BACKGROUND AND OBJECTIVE

To determine the effects of intravitreal injections of erythropoietin in eyes with severe, chronic diabetic macular edema, 5 eyes of 5 patients underwent injections of rHuEPO alpha (EPO).

PATIENTS AND METHODS

All eyes had progressive vision loss and persistent or worsening edema with prior multi-modal treatment. EPO (5U/50 microL) was injected intravitreally every 6 weeks for three doses and followed for an additional 6 weeks with complete ocular examinations, fluorescein angiography, optical coherence tomography (OCT), and central field acuity perimetry.

RESULTS

Visual acuity of all patients was subjectively improved by 3 or more lines in 3 eyes and 1 line in 2 eyes. Visual acuity improved to a larger extent than anatomic improvement by OCT. Clearing of hard exudates but only minor improvement in leakage on fluorescein angiography was observed. Improvement in vision occurred within 1 week after the first injection and was maintained until the end point of the current case series (at 18 weeks after the first injection).

CONCLUSION

This case series seems to show a short-term positive response to EPO for a specific group of patients with chronic diabetic macular edema who were unresponsive to currently available therapies.

摘要

背景与目的

为了确定玻璃体内注射促红细胞生成素对患有严重慢性糖尿病性黄斑水肿的眼睛的影响,对5例患者的5只眼睛进行了重组人促红细胞生成素α(EPO)注射。

患者与方法

所有眼睛在先前接受多模式治疗后均有视力进行性下降以及持续性或进行性水肿。每6周玻璃体内注射一次EPO(5U/50微升),共注射三剂,并在接下来的6周内进行全面的眼部检查、荧光素血管造影、光学相干断层扫描(OCT)以及中心视野视力检查。

结果

所有患者中,3只眼睛的视力主观上提高了3行或更多行,2只眼睛提高了1行。视力提高的程度大于OCT显示的解剖学改善程度。观察到硬性渗出物消退,但荧光素血管造影显示渗漏仅有轻微改善。视力改善在首次注射后1周内出现,并一直维持到本病例系列的终点(首次注射后18周)。

结论

该病例系列似乎显示,对于一组对现有疗法无反应的慢性糖尿病性黄斑水肿患者,EPO有短期阳性反应。

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