玻璃体内注射地塞米松植入物（Ozurdex）对黄斑形态和功能的影响。

Impact of intravitreal dexamethasone implant (Ozurdex) on macular morphology and function.

机构信息

*Department of Ophthalmology, University Scientific Institute San Raffaele, Milan, Italy; and †Department of Ophthalmology, University Paris Est Creteil, Centre Hospitalier Intercommunal de Creteil, Creteil, France.

出版信息

Retina. 2014 Feb;34(2):330-41. doi: 10.1097/IAE.0b013e31829f7495.

DOI:10.1097/IAE.0b013e31829f7495

PMID:23945638

Abstract

PURPOSE

To investigate the impact of intravitreal dexamethasone implant (Ozurdex) on macular morphology and function in eyes with macular edema secondary to central retinal vein occlusion.

METHODS

Twelve treatment-naive patients with decreased visual acuity because of central retinal vein occlusion-related macular edema were enrolled in this prospective uncontrolled study. Patients were treated with intravitreal Ozurdex and followed up at 1 month and 3 months for the evaluation of morphologic and functional outcomes, by means of best-corrected visual acuity, microperimetry, multifocal electroretinography, and customized high-resolution enhanced depth imaging spectral-domain optical coherence tomography scans.

RESULTS

Twelve eyes of 12 patients (10 men, 2 women; mean age 56.2 ± 13.0 years) were included for analysis. At 1 month, mean best-corrected visual acuity, retinal sensitivity (microperimetry), multifocal electroretinography parameters, central macular thickness, and specific neurosensorial retinal measurements improved significantly. We found a significant negative correlation between retinal sensitivity and central macular thickness at 1 month and 3 months (r = -0.831, P = 0.001; r = -0.881, P = 0.001; respectively). Moreover, retinal sensitivity was negatively related to both outer and inner retinal thickness in all four intervals from the fovea. From baseline to Month 1, change in outer retinal thickness was positively related to multifocal electroretinography N1R1 amplitude change (r = 0.698, P = 0.012), whereas change in central macular thickness was negatively related to multifocal electroretinography P1R1 amplitude change (r = -0.701, P = 0.011). At 3 months, improvement of mean retinal sensitivity and central macular thickness slightly decreased.

CONCLUSION

In eyes with macular edema secondary to central retinal vein occlusion, intravitreal dexamethasone provides functional benefits that correlate well with ultrastructural macular changes.

摘要

目的

研究玻璃体内注射地塞米松植入物（Ozurdex）对视网膜中央静脉阻塞相关黄斑水肿所致黄斑形态和功能的影响。

方法

本前瞻性非对照研究纳入了 12 例因视网膜中央静脉阻塞相关黄斑水肿而视力下降的未经治疗的患者。患者接受玻璃体内注射 Ozurdex 治疗，并在 1 个月和 3 个月时进行形态和功能评估，包括最佳矫正视力、微视野计、多焦视网膜电图和定制的高分辨率增强深度成像光谱域光学相干断层扫描检查。

结果

共纳入 12 只眼（12 例患者，10 例男性，2 例女性；平均年龄 56.2±13.0 岁）进行分析。治疗后 1 个月，平均最佳矫正视力、视网膜敏感度（微视野计）、多焦视网膜电图参数、中心黄斑厚度和特定神经感觉视网膜测量值均显著改善。我们发现，治疗后 1 个月和 3 个月时，视网膜敏感度与中心黄斑厚度之间存在显著的负相关（r=-0.831，P=0.001；r=-0.881，P=0.001）。此外，在从黄斑中心到四个不同区域的所有间隔内，视网膜敏感度与外、内视网膜厚度均呈负相关。从基线到 1 个月，外视网膜厚度的变化与多焦视网膜电图 N1R1 振幅的变化呈正相关（r=0.698，P=0.012），而中心黄斑厚度的变化与多焦视网膜电图 P1R1 振幅的变化呈负相关（r=-0.701，P=0.011）。治疗后 3 个月，平均视网膜敏感度和中心黄斑厚度的改善略有下降。