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临床综述:炎症性黄斑水肿治疗进展。

Clinical review: Update on treatment of inflammatory macular edema.

机构信息

Department of Ophthalmology, University Medical Center Utrecht, Utrecht, The Netherlands.

出版信息

Ocul Immunol Inflamm. 2011 Feb;19(1):75-83. doi: 10.3109/09273948.2010.509530. Epub 2010 Oct 31.

Abstract

The aim of this review is to summarize the recent developments in the treatment of inflammatory macular edema (ME). Inflammatory ME represents a major cause of visual loss in uveitis and its adequate management is crucial for the maintenance of useful vision in patients with uveitis. Recent studies favor early treatment of inflammatory ME, even in patients with full visual acuity. After recapitulating the standard treatment modalities for inflammatory ME the authors address novel corticosteroid implants. They review the literature on the efficacy of anti-VEGF agents for inflammatory ME and point out their beneficial, but transient effects. Further, they present recent data on the value of systemic biologics in uveitic ME and evaluate the effectiveness of vitrectomy. Finally, they propose an algorithm for the treatment of inflammatory ME and point out that the individual risk-benefit ratio, especially with systemic immunosuppressive therapy, should always be considered.

摘要

本文旨在总结治疗炎症性黄斑水肿(ME)的最新进展。炎症性 ME 是葡萄膜炎导致视力丧失的主要原因,因此对于葡萄膜炎患者保持有用视力至关重要。最近的研究支持早期治疗炎症性 ME,即使在视力完全正常的患者中也是如此。在回顾炎症性 ME 的标准治疗方法后,作者介绍了新型皮质类固醇植入物。他们综述了抗血管内皮生长因子(VEGF)药物治疗炎症性 ME 的疗效,并指出其有益但短暂的效果。此外,他们介绍了关于在葡萄膜炎性 ME 中使用全身生物制剂的最新数据,并评估了玻璃体切除术的效果。最后,他们提出了炎症性 ME 的治疗算法,并指出应始终考虑个体的风险-效益比,尤其是全身免疫抑制治疗。

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