Brunner M, Haueter I, Valmaggia C
Department of Ophthalmology, Cantonal Hospital St Gallen, St. Gallen, Switzerland.
Klin Monbl Augenheilkd. 2013 Apr;230(4):396-400. doi: 10.1055/s-0032-1328365. Epub 2013 Apr 29.
The efficacy of a single dose of Ozurdex® was evaluated over a 6-month period in eyes with macular edema due to retinal vein occlusion and intraocular inflammatory disease.
20 eyes of 20 consecutive patients with macular edema received a single injection of Ozurdex® (intravitreal dexamethasone implant 0.7 mg). Patients with branch retinal vein occlusion (n = 11), central retinal vein occlusion (n = 6), non-infectious posterior uveitis (n = 1) and Irvine-Gass Syndrome (n = 2) were included. In 10 patients Ozurdex® was used as the first treatment, 10 patients had undergone previous treatments for macular edema. The mean duration from the symptoms to the initiation of the treatment was 14.2 (1-60) months. The follow-up measurements were performed 1, 3 and 6 months after treatment. The main interest of the study was the visual and structural development over the duration of 6 months after a single dose of Ozurdex® with outcome measures including changes in best-corrected visual acuity and central retinal thickness.
At baseline, the mean best-corrected visual acuity of all patients was 50 (± 16) ETDRS letters and the mean central retinal thickness was 632 (± 168.3) microns. Mean follow-up time was 3.4 (± 1.5) months and 7 patients dropped out during the follow-up period (4 patients after 3 months, additional 3 patients after 6 months). One month after treatment, 14 out of 20 patients (70%) showed a complete regression of macular edema, and in 6 cases (30%) it was partially recurrent. The mean best-corrected visual acuity improved to 56 (± 20.8) ETDRS. Central retinal thickness showed a mean decrease to 278 (± 84.9) microns. 6 months after treatment, recurrence was observed in 9 cases out of the remaining 13 patients (69.2%). In 3 cases, macular edema persisted (23.1%) and in one case (7.7%) the macula remained dry. The mean best-corrected visual acuity was 55 (± 13.9) ETDRS letters. The mean central retinal thickness decreased to 603 (± 174.6) microns.
Ozurdex® showed a good effect in the treatment of macular edema one month after its application, namely a temporary decrease in central retinal thickness and a corresponding increase in best-corrected visual acuity. 6 months after treatment, the recurrence rate was high, and only one person with a branch retinal vein occlusion remained relapse-free over the entire follow-up. Based on our data, the patients should be checked at the latest after 3 months and then monthly in order to detect relapse in time and to initiate another treatment if needed.
在6个月的时间里，对因视网膜静脉阻塞和眼内炎症性疾病导致黄斑水肿的眼睛，评估了单剂量Ozurdex®的疗效。
20例连续性黄斑水肿患者的20只眼睛接受了单次Ozurdex®注射（玻璃体内地塞米松植入剂0.7毫克）。纳入了视网膜分支静脉阻塞患者（n = 11）、视网膜中央静脉阻塞患者（n = 6）、非感染性后葡萄膜炎患者（n = 1）和 Irvine-Gass 综合征患者（n = 2）。10例患者将Ozurdex®作为首次治疗，10例患者此前曾接受过黄斑水肿治疗。从出现症状到开始治疗的平均时长为14.2（1 - 60）个月。在治疗后1、3和6个月进行随访测量。该研究的主要关注点是单剂量Ozurdex®给药后6个月期间的视力和结构变化，结果指标包括最佳矫正视力和视网膜中央厚度的变化。
基线时，所有患者的平均最佳矫正视力为50（±16）ETDRS字母，平均视网膜中央厚度为632（±168.3）微米。平均随访时间为3.4（±1.5）个月，7例患者在随访期间退出（3个月后4例，6个月后又有3例）。治疗1个月后，20例患者中有14例（70%）黄斑水肿完全消退，6例（30%）部分复发。平均最佳矫正视力提高到56（±20.8）ETDRS。视网膜中央厚度平均降至278（±84.9）微米。治疗6个月后，其余13例患者中有9例（69.2%）出现复发。3例患者黄斑水肿持续存在（23.1%），1例患者（7.7%）黄斑保持干燥。平均最佳矫正视力为55（±13.9）ETDRS字母。平均视网膜中央厚度降至603（±174.6）微米。
Ozurdex®在应用1个月后对黄斑水肿治疗显示出良好效果，即视网膜中央厚度暂时降低，最佳矫正视力相应提高。治疗6个月后，复发率较高，整个随访期间只有1例视网膜分支静脉阻塞患者未复发。根据我们的数据，患者最迟应在3个月后进行检查，然后每月检查一次，以便及时发现复发，并在需要时启动另一种治疗。
