Department of Ophthalmology, University Scientific Institute San Raffaele, Milan, Italy.
Ophthalmologica. 2013;229(1):21-5. doi: 10.1159/000342160. Epub 2012 Sep 19.
To evaluate the effects of repeated intravitreal dexamethasone implant (IDI) (Ozurdex®) in eyes with macular edema (ME) due to retinal vein occlusion (RVO).
We reviewed the charts of patients with RVO-related ME, who received repeated Ozurdex IDI (0.7 mg) on an 'as-needed' basis. Main outcome measures included changes in best-corrected visual acuity (BCVA), central macular thickness (CMT), retreatment interval, and incidence of side effects.
A total of 33 eyes were included for analysis. Retreatment with Ozurdex was judged necessary after 4.7 ± 1.1 months from the first IDI (1st IDI) and 5.1 ± 1.5 months from the second IDI (2nd IDI). Baseline BCVA was 0.65 ± 0.43 logMAR; it significantly improved to 0.50 ± 0.42 logMAR after 1.4 ± 0.7 months from the 1st IDI (peaking efficacy) (p < 0.001) and to 0.48 ± 0.44 logMAR after 1.8 ± 0.8 months from the 2nd IDI (peaking efficacy) (p < 0.001). CMT decreased from 636 ± 217 µm (baseline) to 300 ± 114 µm, 1.4 ± 0.7 months after the 1st IDI (p < 0.001), and to 298 ± 91 µm, 1.8 ± 0.8 months after the 2nd IDI (p < 0.001). A rebound effect was recorded in 7 eyes after the 1st IDI (mean 168 ± 158 µm) and in 4 eyes after the 2nd IDI (mean 215 ± 199 µm). All eyes with a rebound effect improved again after a 2nd intravitreal Ozurdex injection. No serious adverse events were observed; 12 eyes developed a transient IOP increase, and cataracts were extracted in 2 eyes.
Repeated intravitreal Ozurdex on an 'as-needed' basis, with a retreatment interval <6 months, may produce long-term clinically meaningful benefits in the treatment of ME due to RVO, without other significant side effects than expected after intraocular corticosteroid treatment.
评估重复玻璃体内注射地塞米松植入物（IDI）（Ozurdex®）治疗视网膜静脉阻塞（RVO）相关黄斑水肿（ME）的疗效。
我们回顾了因 RVO 相关 ME 而接受重复 Ozurdex IDI（0.7mg）按需治疗的患者的病历。主要观察指标包括最佳矫正视力（BCVA）、中心黄斑厚度（CMT）、再治疗间隔和不良反应发生率的变化。
共纳入 33 只眼进行分析。从第一次 IDI（1st IDI）开始，Ozurdex 的再治疗被判断为必要的时间为 4.7±1.1 个月，从第二次 IDI（2nd IDI）开始，时间为 5.1±1.5 个月。基线时 BCVA 为 0.65±0.43 logMAR；从第一次 IDI 开始 1.4±0.7 个月后，BCVA 显著改善至 0.50±0.42 logMAR（峰值疗效）（p<0.001），从第二次 IDI 开始 1.8±0.8 个月后，BCVA 进一步改善至 0.48±0.44 logMAR（峰值疗效）（p<0.001）。CMT 从基线时的 636±217µm 下降至第一次 IDI 后 1.4±0.7 个月时的 300±114µm（p<0.001），第二次 IDI 后 1.8±0.8 个月时进一步下降至 298±91µm（p<0.001）。第一次 IDI 后有 7 只眼出现反弹效应（平均 168±158µm），第二次 IDI 后有 4 只眼出现反弹效应（平均 215±199µm）。所有出现反弹效应的眼在第二次玻璃体内注射奥扎格雷后再次改善。未观察到严重不良事件；12 只眼出现短暂的眼压升高，2 只眼行白内障摘除术。
重复玻璃体内注射 Ozurdex（按需），治疗间隔<6 个月，可能为 RVO 相关 ME 的治疗带来长期的临床意义上的获益，且除了预期的眼内皮质类固醇治疗后出现的其他显著副作用外，无其他明显副作用。
