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基于地塞米松的玻璃体内植入物(Ozurdex)对术后及慢性葡萄膜炎性黄斑囊样水肿的反应

Response of Postoperative and Chronic Uveitic Cystoid Macular Edema to a Dexamethasone-Based Intravitreal Implant (Ozurdex).

作者信息

Garweg Justus G, Baglivo Edoardo, Freiberg Florentina J, Pfau Maximilian, Pfister Isabel B, Michels Stephan, Zandi Souska

机构信息

1 Berner Augenklinik am Lindenhofspital, Swiss Eye Institute , Bern, Switzerland .

2 University of Bern , Bern, Switzerland .

出版信息

J Ocul Pharmacol Ther. 2016 Sep;32(7):442-50. doi: 10.1089/jop.2016.0035. Epub 2016 Aug 1.

Abstract

PURPOSE

To survey the clinical responses to treatment of chronic postoperative and uveitic cystoid macular edema (CME) with a dexamethasone-based intravitreal implant (Ozurdex(®)).

METHODS

This retrospective, interventional case series reports on patients with chronic CME after uncomplicated vitrectomy for epiretinal gliosis or phacoemulsification (group 1: 12 eyes) or secondary to noninfectious endogenous uveitis (group 2: 36 eyes). Central retinal thickness (CRT), best-corrected visual acuity (BCVA, logMAR), and intraocular pressure (IOP) throughout follow-up were gleaned from the medical records.

RESULTS

In group 1, CRT decreased, compared with baseline, from 519 ± 43 to 297 ± 23 and 356 ± 49 μm by the 1- and 3-month visit (P = 0.02) and to 429 ± 57 μm before reimplantation. In group 2, CRT decreased from 460 ± 31 to 300 ± 21 and 312 ± 26 μm by the 1- and 3-month follow-up, respectively (P = 0.001), and to 373 ± 32 μm before reimplantation. Complete resolution of CME was achieved in 67% and 94% (groups 1 and 2, respectively) by 1 month and in 42% and 80% by 3 months after injection. In group 1, BCVA improved from 0.46 ± 0.08 to 0.27 ± 0.09 and 0.20 ± 0.06 (P = 0.01) by the 1- and 3-month follow-up, respectively, and to 0.32 ± 0.08 before reimplantation. In group 2, BCVA improved from 0.47 ± 0.06 to 0.34 ± 0.09, 0.26 ± 0.07, and 0.29 ± 0.08 (P < 0.05) at 1 and 3 months of follow-up and before reimplantation, respectively. A significant IOP increase was not observed in either group. Mean time to reimplantation of Ozurdex was 6.4 ± 5.7 and 6.6 ± 3.4 months for postoperative and uveitic CME, respectively.

CONCLUSION

Ozurdex seems to achieve a sustained effect over up to 6 months in postsurgical and uveitic CME.

摘要

目的

探讨地塞米松玻璃体内植入剂(Ozurdex®)治疗慢性术后及葡萄膜炎性黄斑囊样水肿(CME)的临床疗效。

方法

本回顾性、介入性病例系列报告了因视网膜前胶质增生行单纯玻璃体切除术或白内障超声乳化术后发生慢性CME的患者(第1组:12只眼),或继发于非感染性内源性葡萄膜炎的患者(第2组:36只眼)。通过病历收集整个随访过程中的中心视网膜厚度(CRT)、最佳矫正视力(BCVA,logMAR)和眼压(IOP)。

结果

在第1组中,与基线相比,CRT在1个月和3个月随访时分别从519±43降至297±23和356±49μm(P = 0.02),在再次植入前降至429±57μm。在第2组中,CRT在1个月和3个月随访时分别从460±31降至300±21和312±26μm(P = 0.001),在再次植入前降至373±32μm。注射后1个月时,第1组和第2组CME完全消退的比例分别为67%和94%;3个月时分别为42%和80%。在第1组中,BCVA在1个月和3个月随访时分别从0.46±0.08提高到0.27±0.09和0.20±0.06(P = 0.01),在再次植入前提高到0.32±0.08。在第2组中,BCVA在随访1个月、3个月时及再次植入前分别从0.47±0.06提高到0.34±0.09、0.26±0.07和0.29±0.08(P < 0.05)。两组均未观察到眼压显著升高。术后和葡萄膜炎性CME再次植入Ozurdex的平均时间分别为6.4±5.7个月和6.6±3.4个月。

结论

Ozurdex在术后和葡萄膜炎性CME中似乎能在长达6个月的时间内实现持续疗效。

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