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玻璃体内注射地塞米松植入物治疗糖尿病性黄斑水肿的疗效

Efficacy of dexamethasone intravitreal implant for the treatment of diabetic macular edema.

作者信息

Bonnin Sophie, Dupas Bénédicte, Sanharawi Mohamed El, Perol Julien, Erginay Ali, Tadayoni Ramin, Massin Pascale

机构信息

Ophthalmology Department, Lariboisiere Hospital, Paris - France.

出版信息

Eur J Ophthalmol. 2015 Sep-Oct;25(5):448-53. doi: 10.5301/ejo.5000581. Epub 2015 Feb 10.

Abstract

PURPOSE

To assess the efficacy of a single dexamethasone intravitreal implant (Dex-I) injection for the treatment of diabetic macular edema (DME).

METHODS

This was a retrospective chart review of 39 eyes (34 consecutive patients). Best-corrected visual acuity (BCVA), central macular thickness (CMT), and increase in intraocular pressure (IOP) (gt;24 mm Hg) were analyzed before treatment and 2 and 4 months after injection.

RESULTS

Preoperative mean CMT was 559 ± 111 μm and decreased to 338 ± 84 and 477 ± 140 μm 2 and 4 months after injection, respectively. Although all eyes showed a significant decrease in CMT 2 months after injection (p<0.0001), a recurrence of the macular edema was observed 4 months after injection in 79% of eyes. Mean BCVA improvement (logMAR) was 0.13 ± 0.18 (p<0.0001) and 0.07 ± 0.21 (p = 0.049) 2 and 4 months after injection, respectively, without significant difference between vitrectomized and nonvitrectomized eyes. Eight eyes (21%) developed reversible increase in IOP 2 months after injection.

CONCLUSIONS

Thirty percent of DME eyes had gained more than 2 logMAR lines 2 months after Dex-I injection and safety was good. Visual acuity gain was maintained 4 months after injection despite a recurrence of edema in most cases.

摘要

目的

评估单次玻璃体内注射地塞米松植入物(Dex-I)治疗糖尿病性黄斑水肿(DME)的疗效。

方法

这是一项对39只眼(34例连续患者)的回顾性病历分析。分析了治疗前以及注射后2个月和4个月时的最佳矫正视力(BCVA)、黄斑中心厚度(CMT)以及眼压升高情况(眼压>24 mmHg)。

结果

术前平均CMT为559±111μm,注射后2个月和4个月时分别降至338±84μm和477±140μm。尽管所有眼在注射后2个月时CMT均显著降低(p<0.0001),但79%的眼在注射后4个月时观察到黄斑水肿复发。注射后2个月和4个月时平均BCVA改善情况(logMAR)分别为0.13±0.18(p<0.0001)和0.07±0.21(p = 0.049),接受玻璃体切割术的眼和未接受玻璃体切割术的眼之间无显著差异。8只眼(21%)在注射后2个月出现眼压可逆性升高。

结论

30%的DME患眼在注射Dex-I后2个月视力提高超过2行logMAR,安全性良好。尽管大多数病例出现水肿复发,但注射后4个月视力仍得以维持。

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