Breitbach M, Rack D, Dietzel M, Heinz C, Heiligenhaus A
Augenabteilung am St. Franziskus-Hospital, Münster.
Universitätsaugenklinik Essen, Universität Diusburg-Essen.
Klin Monbl Augenheilkd. 2016 May;233(5):601-5. doi: 10.1055/s-0042-102058. Epub 2016 May 17.
To evaluate the efficacy of an intravitreal dexamethasone implant (Ozurdex®) in patients with cystoid macular oedema (CME) suffering from non-infectious uveitis.
Monocentric, retrospective, single-arm analysis in 49 patients (59 implanted eyes) with inactive uveitis, in whom CME had been unresponsive to corticosteroids and/or immunosuppressants and systemic acetazolamide, and who received a dexamethasone implant. Patients were followed up at 6, 12 and 24 weeks after unilateral (n = 39)/bilateral (n = 10) implantation. The primary outcome measure was central foveal thickness (CFT), as measured by Spectralis optical coherence tomography (OCT); secondary outcome measures were improvement in best-corrected visual acuity (BCVA), laser flare photometry and safety measures, including intraocular pressure (IOP) and cataract progression.
At 6, 12 and 24 weeks, mean CFT was reduced (≥ 20 %) in 68, 44 and 45 % and BCVA improved (≥ 2 lines) in 47, 40 and 26 %, respectively, as compared to baseline. At 6, 12 and 24 weeks, significant flare reduction was observed in 70, 41, and 42 %, respectively. Cumulative cataract progression was observed in 12, 18 and 31 % at 6, 12 and 24 weeks, respectively. IOP ≥ 22 mmHg was noted in 5 % at baseline and in 21, 3, and 0 % at 6, 12 and 24 weeks, respectively.
In uveitis patients with CME refractory to systemic anti-inflammatory drugs, the dexamethasone implant improves CME transiently. However, IOP increase and cataract progression are common side effects.
评估玻璃体内注射地塞米松植入剂（Ozurdex®）对患有非感染性葡萄膜炎的黄斑囊样水肿（CME）患者的疗效。
对49例（59只植入眼）非活动性葡萄膜炎患者进行单中心、回顾性、单臂分析，这些患者的CME对皮质类固醇和/或免疫抑制剂以及全身应用乙酰唑胺均无反应，并接受了地塞米松植入剂治疗。在单侧（n = 39）/双侧（n = 10）植入后6、12和24周对患者进行随访。主要观察指标是通过Spectralis光学相干断层扫描（OCT）测量的中心凹厚度（CFT）；次要观察指标是最佳矫正视力（BCVA）的改善情况、激光闪光光度测定以及安全性指标，包括眼压（IOP）和白内障进展情况。
与基线相比，在6、12和24周时，平均CFT分别在68%、44%和45%的患者中降低（≥20%），BCVA分别在47%、40%和26%的患者中提高（≥2行）。在6、12和24周时，分别有70%、41%和42%的患者观察到明显的闪光减少。在6、12和24周时，分别有12%、18%和31%的患者观察到累积性白内障进展。基线时眼压≥22 mmHg的患者占5%，在6、12和24周时分别为21%、3%和0%。
在对全身抗炎药物难治的葡萄膜炎合并CME患者中，地塞米松植入剂可使CME得到短暂改善。然而，眼压升高和白内障进展是常见副作用。
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