Massin Pascale, Erginay Ali, Dupas Bénédicte, Couturier Aude, Tadayoni Ramin
Ophthalmology Department, Lariboisière Hospital, Paris, France.
Clin Ophthalmol. 2016 Jul 8;10:1257-64. doi: 10.2147/OPTH.S105385. eCollection 2016.
To evaluate the efficacy and safety of sustained-delivery fluocinolone acetonide (FAc) intravitreal implant for diabetic macular edema (DME).
Prospective study in patients with DME insufficiently responsive to laser and anti-vascular endothelial growth factor (anti-VEGF). Patients with history of rise of intraocular pressure after intravitreal corticosteroids were excluded.
The macular edema rapidly decreased both in group 1 (prior laser only; n=7 eyes) and group 2 (prior laser and ≥3 monthly anti-VEGF therapy; n=10 eyes) and central subfield thickness was reduced by -299 μm (P=0.008) and -251 μm (P=0.016) at 12 months, respectively. Mean area under the curve from baseline to last value for pseudophakic eyes was +4.2 letters in group 1 and +9.5 letters in group 2. Overall, the FAc implant was well tolerated.
This prospective study confirms the efficacy of the FAc implant in DME patients insufficiently responsive to laser and anti-VEGF. Moreover, with a careful patient selection, our safety results would support an earlier use of FAc in the DME treatment pathway.
评估醋酸氟轻松(FAc)缓释玻璃体植入物治疗糖尿病性黄斑水肿(DME)的疗效和安全性。
对激光和抗血管内皮生长因子(抗VEGF)治疗反应欠佳的DME患者进行前瞻性研究。排除有玻璃体内注射皮质类固醇后眼压升高病史的患者。
第1组(仅接受过激光治疗;n = 7只眼)和第2组(接受过激光治疗且每月至少接受3次抗VEGF治疗;n = 10只眼)的黄斑水肿均迅速减轻,12个月时中心子野厚度分别降低了-299μm(P = 0.008)和-251μm(P = 0.016)。人工晶状体眼从基线到最后一次测量的平均曲线下面积,第1组提高了4.2个字母,第2组提高了9.5个字母。总体而言,FAc植入物耐受性良好。
这项前瞻性研究证实了FAc植入物对激光和抗VEGF治疗反应欠佳的DME患者有效。此外,通过仔细选择患者,我们的安全性结果支持在DME治疗方案中更早使用FAc。