Battaglia Parodi Maurizio, Iacono Pierluigi, Sacconi Riccardo, Parravano Mariacristina, Varano Monica, Bandello Francesco
*Department of Ophthalmology, University Vita-Salute, Scientific Institute San Raffaele, Milan, Italy; and †G.B. Bietti Foundation for Study and Research in Ophthalmology, IRCCS, Rome, Italy.
Retina. 2015 Jul;35(7):1381-6. doi: 10.1097/IAE.0000000000000494.
To evaluate the effects of dexamethasone implant for macular edema secondary to central retinal vein occlusion in patients younger than 50 years.
Patients with no previous treatment, macular edema with central foveal thickness >250 μm and best-corrected visual acuity between 1.30 LogMAR and 0.30 LogMAR were prospectively recruited for a 12-month follow-up study. After baseline dexamethasone implant, re-treatment was performed starting from the fourth month if a best-corrected visual acuity deterioration with central foveal thickness >250 μm occurred after an initial improvement. The primary outcome was the change in the best-corrected visual acuity. Secondary outcomes included the proportion of eyes gaining at least 3 Early Treatment Diabetic Retinopathy Study lines, the change in the central foveal thickness, and the number of treatments.
Mean best-corrected visual acuity changed significantly from 0.60 ± 0.38 LogMAR at baseline to 0.43 ± 0.48 at the 12-month examination (P = 0.03). Eight of 16 eyes (50%) gained 3 Early Treatment Diabetic Retinopathy Study lines. Mean central foveal thickness improved significantly from 705 ± 202 μm at baseline to 408 ± 196 μm at 12-month visit (P < 0.001). The patients received a mean of 1.8 ± 0.9 implants with 8/16 eyes and 3/16 receiving 1 and 2 implants, respectively.
This present investigation indicates that dexamethasone implant can provide a 3-line improvement in half of the patients younger than 50 years and affected by macular edema secondary to central retinal vein occlusion.
评估地塞米松植入物对50岁以下视网膜中央静脉阻塞继发黄斑水肿患者的疗效。
前瞻性招募未接受过治疗、黄斑水肿且中心凹厚度>250μm、最佳矫正视力在1.30 LogMAR至0.30 LogMAR之间的患者进行为期12个月的随访研究。在基线地塞米松植入后，如果在初始改善后出现最佳矫正视力下降且中心凹厚度>250μm，则从第四个月开始进行再次治疗。主要结局是最佳矫正视力的变化。次要结局包括至少提高3行早期糖尿病视网膜病变研究视力的眼比例、中心凹厚度的变化以及治疗次数。
平均最佳矫正视力从基线时的0.60±0.38 LogMAR显著变化至12个月检查时的0.43±0.48（P = 0.03）。16只眼中有8只（50%）提高了3行早期糖尿病视网膜病变研究视力。平均中心凹厚度从基线时的705±202μm显著改善至12个月随访时的408±196μm（P < 0.001）。患者平均植入1.8±0.9次，16只眼中8只植入1次，3只植入2次。
本研究表明，地塞米松植入物可使一半50岁以下视网膜中央静脉阻塞继发黄斑水肿的患者视力提高3行。
