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地塞米松玻璃体内植入物治疗玻璃体切割术后糖尿病性黄斑水肿。

Dexamethasone intravitreal implant for treatment of diabetic macular edema in vitrectomized patients.

机构信息

Retina-Vitreous Associates Medical Group, Los Angeles, California, USA.

出版信息

Retina. 2011 May;31(5):915-23. doi: 10.1097/IAE.0b013e318206d18c.

Abstract

PURPOSE

To evaluate the safety and efficacy of Ozurdex (dexamethasone intravitreal implant) 0.7 mg in the treatment of diabetic macular edema in vitrectomized eyes.

METHODS

This was a prospective, multicenter, open-label, 26-week study. Fifty-five patients with treatment-resistant diabetic macular edema and a history of previous pars plana vitrectomy in the study eye received a single intravitreal injection of 0.7-mg dexamethasone intravitreal implant. The primary efficacy outcome measure was the change in central retinal thickness from baseline to Week 26 measured by optical coherence tomography.

RESULTS

The mean age of patients was 62 years. The mean duration of diabetic macular edema was 43 months. The mean (95% confidence interval) change from baseline central retinal thickness (403 μm) was -156 μm (-190, -122 μm) at Week 8 (P < 0.001) and -39 μm (-65, -13 μm) at Week 26 (P = 0.004). The mean (95% CI) increase in best-corrected visual acuity from baseline (54.5 letters) was 6.0 letters (3.9, 8.1 letters) at Week 8 (P < 0.001) and 3.0 letters (0.1, 6.0 letters) at Week 26 (P = 0.046). At Week 8, 30.4% of patients had gained ≥10 letters in best-corrected visual acuity. Conjunctival hemorrhage, conjunctival hyperemia, eye pain, and increased intraocular pressure were the most common adverse events.

CONCLUSION

Treatment with dexamethasone intravitreal implant led to statistically and clinically significant improvements in both vision and vascular leakage from diabetic macular edema in difficult-to-treat vitrectomized eyes and had an acceptable safety profile.

摘要

目的

评估 0.7mg 曲安奈德玻璃体腔内植入剂(Ozurdex)治疗玻璃体切割术后糖尿病性黄斑水肿的安全性和疗效。

方法

这是一项前瞻性、多中心、开放性、26 周研究。55 例既往患糖尿病性黄斑水肿且曾接受过研究眼玻璃体切除术的治疗抵抗患者接受了单次玻璃体腔内注射 0.7mg 曲安奈德玻璃体腔内植入剂。主要疗效评估指标为光学相干断层扫描测量的从基线至 26 周时中央视网膜厚度的变化。

结果

患者的平均年龄为 62 岁。糖尿病性黄斑水肿的平均病程为 43 个月。从基线中央视网膜厚度(403μm)的平均(95%置信区间)变化在第 8 周时为-156μm(-190,-122μm)(P<0.001),在第 26 周时为-39μm(-65,-13μm)(P=0.004)。从基线(54.5 个字母)最佳矫正视力的平均(95%CI)增加量在第 8 周时为 6.0 个字母(3.9,8.1 个字母)(P<0.001),在第 26 周时为 3.0 个字母(0.1,6.0 个字母)(P=0.046)。在第 8 周时,30.4%的患者最佳矫正视力增加了≥10 个字母。结膜下出血、结膜充血、眼痛和眼内压升高是最常见的不良事件。

结论

对于难以治疗的玻璃体切割术后眼睛,曲安奈德玻璃体腔内植入剂治疗可导致视力和糖尿病性黄斑水肿血管渗漏的统计学和临床显著改善,且具有可接受的安全性。

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