Mylonas Georgios, Georgopoulos Michael, Malamos Panagiotis, Georgalas Ilias, Koutsandrea Chryssanthi, Brouzas Dimitrios, Sacu Stefan, Perisanidis Christos, Schmidt-Erfurth Ursula
a Department of Ophthalmology , Medical University of Vienna , Vienna , Austria.
b 1st Department of Ophthalmology , "G. Gennimatas" General Hospital of Athens, University of Athens , Athens , Greece.
Curr Eye Res. 2017 Apr;42(4):648-652. doi: 10.1080/02713683.2016.1214968. Epub 2016 Sep 9.
To evaluate the efficacy of the treatment with intravitreal triamcinolone acetonide or dexamethasone intravitreal implant in patients with postoperative cystoid macular edema (PCME).
Thirty eyes of 29 patients with PCME were randomized into two groups: one group initially received an injection of 4 mg triamcinolone; retreatment after 3 months was dependent on functional and anatomic outcome in a PRN regimen. The second group received a single injection of the dexamethasone intravitreal implant (Ozurdex). Patients were followed for 6 months. The main outcomes were best-corrected visual acuity (BCVA) and central millimeter retinal thickness (CMMT).
Mean BCVA improved significantly in both groups at 3 months (p ≤ 0.05) and 6 months (p ≤ 0.05) after treatment. There was no statistically significant difference between the two groups in visual acuity improvement at 3 months (p > 0.05) or 6 months (p > 0.05). Mean CMMT of both groups also decreased significantly after treatment at 3 and 6 months (both p ≤ 0.05) and the reduction was significantly superior in the triamcinolone group compared to ozurdex group at 1 week and 6 months (p ≤ 0.05). All cases with intraocular hypertension were managed with IOP-lowering medication and no surgery was required during the study. One patient was excluded because of endophthalmitis in the triamcinolone group.
Intravitreal triamcinolone and dexamethasone implant are both equally effective in increasing visual acuity in patients with PCME at a 6-month follow-up. However, macular edema seems to respond more rapidly with intravitreal triamcinolone, and 3-monthly repetitive injections maintain the reduction in retinal thickness better than a single dexamethasone implant at the first 6 months of follow-up period.
评估玻璃体内注射曲安奈德或地塞米松玻璃体内植入物治疗术后黄斑囊样水肿（PCME）患者的疗效。
将29例PCME患者的30只眼随机分为两组：一组最初接受4mg曲安奈德注射；3个月后根据按需治疗方案，根据功能和解剖学结果决定是否再次治疗。第二组接受单次地塞米松玻璃体内植入物（Ozurdex）注射。对患者进行6个月的随访。主要观察指标为最佳矫正视力（BCVA）和中心视网膜厚度（CMMT）。
两组在治疗后3个月（p≤0.05）和6个月（p≤0.05）时，平均BCVA均有显著改善。两组在3个月（p>0.05）和6个月（p>0.05）时视力改善情况无统计学显著差异。两组的平均CMMT在治疗后3个月和6个月时也均显著降低（均p≤0.05），在1周和6个月时，曲安奈德组的降低幅度明显优于Ozurdex组（p≤0.05）。所有眼压升高的病例均采用降低眼压药物治疗，研究期间无需手术。曲安奈德组有1例患者因眼内炎被排除。
在6个月的随访中，玻璃体内注射曲安奈德和地塞米松植入物在提高PCME患者视力方面同样有效。然而，玻璃体内注射曲安奈德似乎能使黄斑水肿反应更快，在随访的前6个月，每3个月重复注射比单次地塞米松植入物能更好地维持视网膜厚度的降低。
