Yumusak Erhan, Buyuktortop Nesrin, Ornek Kemal
Department of Ophthalmology, Kırıkkale University Faculty of Medicine, Kırıkkale - Turkey.
Eur J Ophthalmol. 2016 Jan-Feb;26(1):54-9. doi: 10.5301/ejo.5000637. Epub 2015 Jun 11.
To compare the short-term results of the efficacy and safety of dexamethasone intravitreal implant (DEX), ranibizumab (RAN), and intravitreal triamcinolone acetonide (IVTA) in macular edema secondary to branch retinal vein occlusion (BRVO).
One eye each of 32 patients who were treated with intravitreal injections for macular edema secondary to BRVO was studied. This retrospective study included 3 groups. The patients received DEX in group 1 (n = 11), RAN in group 2 (n = 11), and IVTA in group 3 (n = 10). Data were collected before and after the injections at the first and third months. Best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) were analyzed statistically.
The median duration of the follow-up was 3.0 months in overall groups. The BCVA increased significantly in all groups (p = 0.018, p = 0.034, p = 0.014, respectively). The CMT increased significantly in groups 1 and 3 (p = 0.02, p<0.001, respectively), but not in group 2 (p = 0.14). The IOP increased significantly in groups 1 and 3 (p = 0.05, p<0.001, respectively). Antiglaucomatous treatment was required only in group 3. Cataract developed in 2 patients (20%) in group 3 and surgery was required.
Although RAN was the safest among the 3 agents, DEX and IVTA reduced CMT more than RAN, while significant improvement was achieved in BCVA in all groups. All 3 agents can be effectively used in the treatment of macular edema due to BRVO.
比较地塞米松玻璃体内植入物(DEX)、雷珠单抗(RAN)和玻璃体内注射曲安奈德(IVTA)治疗视网膜分支静脉阻塞(BRVO)继发黄斑水肿的短期疗效和安全性。
对32例接受玻璃体内注射治疗BRVO继发黄斑水肿的患者的单眼进行研究。这项回顾性研究包括3组。第1组(n = 11)患者接受DEX治疗,第2组(n = 11)患者接受RAN治疗,第3组(n = 10)患者接受IVTA治疗。在注射前以及注射后第1个月和第3个月收集数据。对最佳矫正视力(BCVA)、中心黄斑厚度(CMT)和眼压(IOP)进行统计学分析。
所有组的中位随访时间为3.0个月。所有组的BCVA均显著提高(分别为p = 0.018、p = 0.034、p = 0.014)。第1组和第3组的CMT显著增加(分别为p = 0.02、p<0.001),但第2组未增加(p = 0.14)。第1组和第3组的IOP显著增加(分别为p = 0.05、p<0.001)。仅第3组需要进行抗青光眼治疗。第3组有2例患者(20%)发生白内障,需要进行手术。
虽然RAN在这3种药物中是最安全的,但DEX和IVTA降低CMT的效果比RAN更显著,而所有组的BCVA均有显著改善。这3种药物均可有效用于治疗BRVO所致的黄斑水肿。