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缓释地塞米松植入剂:扩大在玻璃体视网膜疾病中的应用指征

The Sustained-Release Dexamethasone Implant: Expanding Indications in Vitreoretinal Disease.

作者信息

Kapoor K G, Wagner M G, Wagner A L

机构信息

a Wagner Macula and Retina Center , Virginia Beach , Virginia , USA .

b Eastern Virginia Medical School Department of Ophthalmology , Norfolk , Virginia , USA , and.

出版信息

Semin Ophthalmol. 2015;30(5-6):475-81. doi: 10.3109/08820538.2014.889179. Epub 2014 Mar 21.

DOI:10.3109/08820538.2014.889179
PMID:24654698
Abstract

Corticosteroids play an important role in the therapeutic approach to vitreoretinal disease. The Ozurdex implant (DEX Implant 0.7 mg, Ozurdex, Allergan Inc., Irvine, CA, USA) offers sustained release of dexamethasone in the vitreous cavity, and this novel drug delivery system has proven useful both in improving clinical outcomes and in reducing injection burden. While the Food and Drug Administration approves the use of the DEX implant in retinal vein occlusions and non-infectious posterior uveitis, its utilization continues to expand in its breadth of diversity across myriad vitreoretinal conditions. Additionally, modified injection techniques are evolving to improve the safety profile of the DEX implant in eyes that are often considered to have relative contraindications to its use, further extending its application. This review aims to evaluate the evidence supporting the expanding indications and injection techniques of the DEX sustained-release implant in vitreoretinal disease, and explores potential future indications for its use. Arenas for future research are also identified to further elucidate the precise role of the DEX implant in our current treatment model. Increased awareness of effective and safe uses of the DEX implant can refine our therapeutic approach to vitreoretinal disease and ultimately improve patient outcomes.

摘要

皮质类固醇在玻璃体视网膜疾病的治疗方法中发挥着重要作用。Ozurdex植入物(DEX植入物0.7毫克,Ozurdex,美国艾尔建公司,加利福尼亚州欧文市)可在玻璃体腔中持续释放地塞米松,这种新型药物递送系统已被证明在改善临床结果和减轻注射负担方面均有用处。虽然美国食品药品监督管理局批准在视网膜静脉阻塞和非感染性后葡萄膜炎中使用DEX植入物,但其应用范围在各种玻璃体视网膜疾病中仍在不断扩大。此外,改良的注射技术也在不断发展,以改善DEX植入物在通常被认为相对禁忌使用的眼中的安全性,从而进一步扩大其应用范围。本综述旨在评估支持DEX缓释植入物在玻璃体视网膜疾病中不断扩大的适应证和注射技术的证据,并探讨其潜在的未来应用适应证。还确定了未来的研究领域,以进一步阐明DEX植入物在我们当前治疗模式中的精确作用。提高对DEX植入物有效和安全使用的认识可以完善我们对玻璃体视网膜疾病的治疗方法,并最终改善患者的治疗效果。

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