Wu Lihteh, Arevalo J Fernando, Hernandez-Bogantes Erick, Roca José A
Instituto de Cirugia Ocular, Apdo 144-1225 Plaza Mayor, San José, Costa Rica.
Int Ophthalmol. 2012 Jun;32(3):235-43. doi: 10.1007/s10792-012-9559-8. Epub 2012 Apr 8.
Inflammation is the major etiologic factor in the development of pseudophakic cystoid macular edema (CME). Several soluble mediators of inflammation such as tumor necrosis factor alpha (TNF-α) have been implicated in the pathogenesis of ocular inflammation. The purpose of this study is to report the short-term visual and anatomic outcomes following intravitreal injections of infliximab in eyes with refractory CME secondary to cataract surgery. An interventional, retrospective study of 7 eyes with refractory CME that were injected with 1 mg of infliximab. The main outcome measures were best-corrected visual acuity (BCVA) and central macular thickness (CMT) at 6-month follow-up. At the 6 month follow-up, BCVA improved from 1.14 ± 0.59 logMAR at baseline to 0.51 ± 0.35 logMAR (p = 0.0156). CMT also improved from 584 ± 159 μm at baseline to 327 ± 127 μm at 6 months (p = 0.0111). No systemic adverse events were reported in these patients. There was a single episode of uveitis that responded to topical steroids. Inhibition of TNF-α may be beneficial in the treatment of refractory pseudophakic CME.
炎症是人工晶状体性黄斑囊样水肿(CME)发生发展的主要病因。多种炎症可溶性介质,如肿瘤坏死因子α(TNF-α),与眼部炎症的发病机制有关。本研究的目的是报告玻璃体内注射英夫利昔单抗治疗白内障手术后难治性CME患者的短期视力和解剖学结果。一项对7例难治性CME患者进行的干预性回顾性研究,这些患者接受了1 mg英夫利昔单抗的注射。主要观察指标为随访6个月时的最佳矫正视力(BCVA)和中心黄斑厚度(CMT)。在6个月随访时,BCVA从基线时的1.14±0.59 logMAR提高到0.51±0.35 logMAR(p = 0.0156)。CMT也从基线时的584±159μm改善到6个月时的327±127μm(p = 0.0111)。这些患者未报告全身性不良事件。仅发生1次葡萄膜炎,局部应用类固醇治疗有效。抑制TNF-α可能有助于治疗难治性人工晶状体性CME。