Pacella Fernanda, La Torre Giuseppe, Basili Stefania, Autolitano Monica, Pascarella Antonella, Lenzi Tommaso, Pacella Elena
a Department of Sense Organs , "Sapienza" University of Rome , Rome , Italy.
b Department of Public Health and Infectious Diseases , Sapienza University of Rome , Rome , Italy.
Cutan Ocul Toxicol. 2017 Sep;36(3):224-230. doi: 10.1080/15569527.2016.1254648. Epub 2017 Jan 11.
The aim of this study was to compare early and late injections of intravitreal dexamethasone implant in patients affected by central retinal vein occlusion (CRVO) or branch retinal vein occlusion (BRVO) with a six-months follow-up. We assessed whether an earlier treatment start (within seven days from diagnosis) could be more beneficial than a delayed (or late) treatment start (after seven days).
The study included 81 patients (81 eyes) affected by retinal vein occlusion. Best corrected visual acuity was assessed through Early Treatment Diabetic Retinopathy Study (ETDRS) while central macular thickness (CMT) was measured by spectral-domain optical coherence tomography.
Both types of patients had a positive therapeutic response to dexamethasone, with an increase in visual acuity (ETDRS) and CMT reduction. CRVO patients were characterized by lower ETDRS values at baseline and at the end of the follow-up as compared to BRVO. CRVO patients showed higher CMT values at baseline, after three and six months from injection. No significant differences in therapeutic response to dexamethasone were observed between patients treated early or late, regardless of RVO type.
This study demonstrates that the therapeutic properties of dexamethasone implant are not significantly influenced by an early or late treatment start in patients affected by BRVO and CRVO, although its therapeutic efficacy seems greater in the former type.
本研究旨在比较玻璃体内注射地塞米松植入物治疗视网膜中央静脉阻塞(CRVO)或视网膜分支静脉阻塞(BRVO)患者时早期注射与晚期注射,并进行为期六个月的随访。我们评估了更早开始治疗(诊断后七天内)是否比延迟(或晚期)开始治疗(七天后)更有益。
该研究纳入了81例视网膜静脉阻塞患者(81只眼)。通过糖尿病视网膜病变早期治疗研究(ETDRS)评估最佳矫正视力,同时采用光谱域光学相干断层扫描测量中心黄斑厚度(CMT)。
两种类型的患者对地塞米松均有积极的治疗反应,视力(ETDRS)提高,CMT降低。与BRVO患者相比,CRVO患者在基线和随访结束时的ETDRS值较低。CRVO患者在注射后三个月和六个月时的基线CMT值较高。无论RVO类型如何,早期或晚期治疗的患者对地塞米松的治疗反应均无显著差异。
本研究表明,地塞米松植入物的治疗特性在BRVO和CRVO患者中不受早期或晚期开始治疗的显著影响,尽管其治疗效果在前一种类型中似乎更大。