Bandello Francesco, Parravano Mariacristina, Cavallero Edoardo, Cascavilla Maria Lucia, Triolo Giacinto, Querques Lea, Borrelli Enrico, Giorno Paola, Varano Monica, Lattanzio Rosangela, Querques Giuseppe
Department of Ophthalmology, University Scientific Institute San Raffaele, Milan, Italy.
Ophthalmic Res. 2015;53(4):207-16. doi: 10.1159/000381187. Epub 2015 Apr 16.
To evaluate changes in macular morphology and function after repeated intravitreal dexamethasone implant (Ozurdex®) for macular edema (ME) due to retinal vein occlusion (RVO).
Consecutive treatment-naïve patients with ME secondary to RVO were treated with Ozurdex and followed up to 12 months to evaluate functional and morphological outcomes by means of best-corrected visual acuity (BCVA) and microperimetry and by enhanced depth imaging optical coherence tomography, respectively.
Thirty-five eyes of 35 patients were included for the analysis (26 central RVO, 9 branch RVO). During the 12-month study period, 8 of the 35 eyes (23%) underwent 1 intravitreal dexamethasone implant, 13 of the 35 eyes (37%) underwent 2, and 14 of the 35 eyes (40%) underwent 3 intravitreal dexamethasone implants. At 1 month from the 1st intravitreal dexamethasone implant, the mean BCVA, retinal sensitivity and central macular thickness (CMT) significantly improved compared to the baseline values. At 3 months, the mean BCVA improvement was no more significant, while retinal sensitivity further improved and CMT slightly worsened, remaining, however, significantly better than at baseline. At 12 months, those eyes that had undergone 2 retreatments showed a significant improvement of the mean BCVA, mean retinal sensitivity and CMT compared to the baseline values [0.61 ± 0.29 logarithm of the minimum angle of resolution (LogMAR) vs. 0.82 ± 0.33 LogMAR, p = 0.011; 12.94 ± 4.73 dB vs. 10.75 ± 3.27 dB, p = 0.043, and 321 ± 91 µm vs. 735 ± 169 µm, p = 0.001, respectively]. In those eyes that had undergone only 1 retreatment, a significant improvement was recorded only for the CMT (500 ± 224 µm vs. 695 ± 302 µm, p = 0.044). The mean retreatment interval between the 1st and the 2nd injection was 4.5 ± 1.1 months (range 3-7 months), and between the 2nd and the 3rd injection it was 4.1 ± 1 months (range 3-6 months).
In eyes with ME secondary to RVO, Ozurdex produces functional benefits as early as 1 month after treatment/retreatment. Current optical coherence tomography and microperimetry findings confirm the concept that, in most cases, the optimum retreatment interval should be <6 months from the 1st injection.
评估因视网膜静脉阻塞（RVO）导致的黄斑水肿（ME）患者多次玻璃体内注射地塞米松植入剂（Ozurdex®）后黄斑形态和功能的变化。
对连续的初治RVO继发ME患者使用Ozurdex进行治疗，并随访12个月，分别通过最佳矫正视力（BCVA）、微视野检查以及增强深度成像光学相干断层扫描来评估功能和形态学结果。
纳入35例患者的35只眼进行分析（26例为中央RVO，9例为分支RVO）。在12个月的研究期间，35只眼中有8只眼（23%）接受了1次玻璃体内地塞米松植入，35只眼中有13只眼（37%）接受了2次，35只眼中有14只眼（40%）接受了3次玻璃体内地塞米松植入。在首次玻璃体内地塞米松植入后1个月，平均BCVA、视网膜敏感度和中心黄斑厚度（CMT）与基线值相比显著改善。在3个月时，平均BCVA改善不再显著，而视网膜敏感度进一步提高，CMT略有恶化，但仍显著优于基线。在12个月时，接受2次再治疗的眼与基线值相比，平均BCVA、平均视网膜敏感度和CMT均有显著改善[最小分辨角对数（LogMAR）为0.61±0.29 vs. 0.82±0.33，p = 0.011；12.94±4.73 dB vs. 10.75±3.27 dB，p = 0.043，以及321±91 µm vs. 735±169 µm，p = 0.001]。仅接受1次再治疗的眼中，仅CMT有显著改善（500±224 µm vs. 695±302 µm，p = 0.044）。首次和第二次注射之间的平均再治疗间隔为4.5±1.1个月（范围3 - 7个月），第二次和第三次注射之间为4.1±1个月（范围3 - 6个月）。
在RVO继发ME的眼中，Ozurdex在治疗/再治疗后1个月即可产生功能益处。当前光学相干断层扫描和微视野检查结果证实了在大多数情况下，最佳再治疗间隔应在首次注射后<6个月的概念。
