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玻璃体内注射醋酸氟轻松缓释植入物治疗对现有疗法反应欠佳的慢性糖尿病性黄斑水肿患者的疗效与安全性:一项真实世界研究

Efficacy and safety of sustained-delivery fluocinolone acetonide intravitreal implant in patients with chronic diabetic macular edema insufficiently responsive to available therapies: a real-life study.

作者信息

Massin Pascale, Erginay Ali, Dupas Bénédicte, Couturier Aude, Tadayoni Ramin

机构信息

Ophthalmology Department, Lariboisière Hospital, Paris, France.

出版信息

Clin Ophthalmol. 2016 Jul 8;10:1257-64. doi: 10.2147/OPTH.S105385. eCollection 2016.

Abstract

PURPOSE

To evaluate the efficacy and safety of sustained-delivery fluocinolone acetonide (FAc) intravitreal implant for diabetic macular edema (DME).

PATIENTS AND METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

患者与方法

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。

结果

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。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e232/4944911/923e13c8be24/opth-10-1257Fig1.jpg

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