Zarranz-Ventura Javier, Carreño Ester, Johnston Robert L, Mohammed Quresh, Ross Adam H, Barker Carl, Fonollosa Alex, Artaraz Joseba, Pelegrin Laura, Adan Alfredo, Lee Richard W, Dick Andrew D, Sallam Ahmed
Bristol Eye Hospital, Bristol, United Kingdom; Gloucestershire Hospitals National Health Service Trust, Cheltenham, United Kingdom; Institut Clínic d'Oftalmologia (ICOF), Hospital Clínic, Barcelona, Spain.
Bristol Eye Hospital, Bristol, United Kingdom.
Am J Ophthalmol. 2014 Dec;158(6):1136-1145.e5. doi: 10.1016/j.ajo.2014.09.003. Epub 2014 Sep 8.
To identify clinical outcomes and treatment patterns of intravitreal dexamethasone implant (Ozurdex; Allergan, Inc) in noninfectious uveitis in the clinical setting.
Multicenter retrospective cohort study.
Eighty-two eyes (63 patients) receiving 142 implant injections over 35 months were included. Treatment indication, uveitis diagnosis, visual acuity, intraocular pressure, vitreous haze score, central retinal thickness by optical coherence tomography, phakic status, number of injections, time to reinjection, systemic treatments, and complications data were collected. Time to visual acuity and vitreous haze score improvement as per the Standardization of Uveitis Nomenclature guidelines were also determined.
The probability of visual acuity improvement (≥0.3 logarithm of the minimal angle of resolution units improvement) was 39% at 1 month, 49% at 3 months, 52% at 6 months, and 58% at 12 months. Eyes with baseline vitritis (vitreous haze score ≥+0.5, n = 45) had a probability of vitreous haze score improvement (2-step decrease or change from +0.5 to 0) at 2 weeks of 41%, at 1 month 63%, at 3 months 73%, at 6 months 79%, and at 12 months 88%. In eyes that completed 12-month follow-up (n = 54), 40.7% underwent 2 injections (mean time to second injection of 6.6 ± 1.9 months) and 11.2% required ≥3 injections (mean time to third injection of 11 ± 1.5 months).
Dexamethasone implant use in uveitis provides favorable visual acuity and vitreous haze score outcomes but requires repeated injections, an important consideration when choosing intraocular treatment as a route to controlling uveitis.
确定玻璃体内注射地塞米松植入剂（Ozurdex；爱尔康公司）在临床环境中治疗非感染性葡萄膜炎的临床疗效和治疗模式。
多中心回顾性队列研究。
纳入82只眼（63例患者），在35个月内接受了142次植入剂注射。收集治疗指征、葡萄膜炎诊断、视力、眼压、玻璃体混浊评分、光学相干断层扫描测量的中央视网膜厚度、晶状体状态、注射次数、再次注射时间、全身治疗及并发症数据。还根据葡萄膜炎命名标准化指南确定视力和玻璃体混浊评分改善的时间。
视力改善（最小分辨角对数单位改善≥0.3）的概率在1个月时为39%，3个月时为49%，6个月时为52%，12个月时为58%。基线时有玻璃体炎（玻璃体混浊评分≥+0.5，n = 45）的眼，玻璃体混浊评分改善（下降2级或从+0.5变为0）的概率在2周时为41%，1个月时为63%，3个月时为73%，6个月时为79%，12个月时为88%。在完成12个月随访的眼中（n = 54），40.7%接受了2次注射（第二次注射的平均时间为6.6±1.9个月），11.2%需要≥3次注射（第三次注射的平均时间为11±1.5个月）。
在葡萄膜炎中使用地塞米松植入剂可带来良好的视力和玻璃体混浊评分结果，但需要重复注射，这是选择眼内治疗作为控制葡萄膜炎途径时的一个重要考虑因素。
