Bonnin Sophie, Dupas Bénédicte, Sanharawi Mohamed El, Perol Julien, Erginay Ali, Tadayoni Ramin, Massin Pascale
Ophthalmology Department, Lariboisiere Hospital, Paris - France.
Eur J Ophthalmol. 2015 Sep-Oct;25(5):448-53. doi: 10.5301/ejo.5000581. Epub 2015 Feb 10.
To assess the efficacy of a single dexamethasone intravitreal implant (Dex-I) injection for the treatment of diabetic macular edema (DME).
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.
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.
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.
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。
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)。
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。
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。