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局部用倍他米松-环糊精微球滴眼液治疗糖尿病性黄斑水肿。

Topical dexamethasone-cyclodextrin microparticle eye drops for diabetic macular edema.

机构信息

Department of Ophthalmology, Shimane University Faculty of Medicine, Enya 89-1, Izumo, Shimane 693-8501, Japan.

出版信息

Invest Ophthalmol Vis Sci. 2011 Oct 10;52(11):7944-8. doi: 10.1167/iovs.11-8178.

Abstract

PURPOSE

To test the safety and efficacy of topical 1.5% dexamethasone aqueous eye drops with cyclodextrin microparticles for diabetic macular edema (DME).

METHODS

Nineteen eyes of 19 consecutive patients with DME were administered dexamethasone-cyclodextrin eye drops three or six times a day for 4 weeks and then observed for 4 weeks without treatment. Visual acuity, intraocular pressure, and spectral domain optical coherent tomography-measured central macular thickness recordings at weeks 0 (baseline), 4, and 8. These parameters were compared using Bonferroni-corrected paired t-tests.

RESULTS

At weeks 0, 4, and 8, logMAR visual acuity (mean ± SD) was 0.52 ± 0.41, 0.37 ± 0.40 (P = 0.0025 vs. baseline), and 0.45 ± 0.41, respectively; central macular thickness (μm) was 512 ± 164, 399 ± 154 (P = 0.0016 vs. baseline), and 488 ± 172 (P = 0.0116 versus week 4), respectively; and intraocular pressure (mm Hg) was 15.2 ± 3.1, 17.4 ± 4.2 (P = 0.0015 vs. baseline) and 15.8 ± 4.0, respectively. At week 4, in 12 (63%) of 19 eyes, central macular thickness had decreased more than 10%, and the mean change was -20% (-65% to +10%). In 14 of 19 eyes (74%) visual acuity (logMAR) had improved more than 0.1 at week 4. No subjects showed severe adverse effects related to the eye drops.

CONCLUSIONS

Based on this short pilot study, topical dexamethasone-cyclodextrin eye drops are well tolerated, decrease central macular thickness, and improve visual acuity in DME. The results encourage comparative studies between dexamethasone cyclodextrin microparticle eye drops and other treatments for DME. (http://www.umin.ac.jp/ctr number, UMIN000001790.).

摘要

目的

测试含有环糊精微粒的 1.5%地塞米松眼用水溶液治疗糖尿病性黄斑水肿(DME)的安全性和疗效。

方法

对 19 例 DME 连续患者的 19 只眼,每天给予地塞米松-环糊精滴眼液 3 至 6 次,持续 4 周,然后不治疗观察 4 周。在第 0 周(基线)、第 4 周和第 8 周,通过频域光学相干断层扫描测量中央黄斑厚度记录,评估视力、眼内压。使用 Bonferroni 校正配对 t 检验比较这些参数。

结果

在第 0 周、第 4 周和第 8 周,对数最小分辨角对数视力(logMAR)分别为 0.52 ± 0.41、0.37 ± 0.40(P = 0.0025 与基线相比)和 0.45 ± 0.41;中央黄斑厚度(μm)分别为 512 ± 164、399 ± 154(P = 0.0016 与基线相比)和 488 ± 172(P = 0.0116 与第 4 周相比);眼内压(mmHg)分别为 15.2 ± 3.1、17.4 ± 4.2(P = 0.0015 与基线相比)和 15.8 ± 4.0。在第 4 周,19 只眼中有 12 只(63%)的中央黄斑厚度减少超过 10%,平均变化为-20%(-65%至+10%)。在第 4 周,19 只眼中有 14 只(74%)的视力(logMAR)提高了 0.1 以上。没有受试者出现与滴眼液相关的严重不良反应。

结论

基于这项短期的初步研究,局部使用地塞米松-环糊精滴眼液耐受性良好,可降低 DME 的中央黄斑厚度并提高视力。结果鼓励在 DME 中比较地塞米松环糊精微粒滴眼液与其他治疗方法的研究。(http://www.umin.ac.jp/ctr number,UMIN000001790.)。

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