Elbay Ahmet, Ozdemir Hakan, Koytak Arif, Melikov Arif
Department of Ophthalmology, Bezmialem Vakif University School of Medicine , Istanbul, Turkey .
J Ocul Pharmacol Ther. 2017 Jul/Aug;33(6):473-479. doi: 10.1089/jop.2016.0187. Epub 2017 Apr 4.
To evaluate the effect of intravitreal dexamethasone implant (Ozurdex) treatment on serous macular detachment (SMD) in patients with nonischemic central retinal vein occlusion (CRVO).
Retrospective, interventional, noncomparative case series was conducted. Twenty-four eyes of 24 patients with macular edema (ME) and SMD secondary to nonischemic CRVO made up the study population. Patients who had received intravitreal triamcinolone and/or antivascular endothelial growth factor treatment and/or had undergone retinal photocoagulation were excluded from the study. After Ozurdex injection, visual and anatomical responses were observed.
The mean follow-up time was 9.96 ± 2.44 months (minimum 7, maximum 14). After injection of Ozurdex, ME and SMD regressed except for 1 patient. Twenty cases showed relapse within a 5.45 ± 1.43 months mean time. Seventeen of them had SMD. Eight cases revealed a second relapse and 1 case revealed a third relapse after retreatments. The mean time for the second relapse was 5.50 ± 1.19 months. The height of SMD was found to be lower in all follow-up examinations-including relapses-than baseline measurements. The median SMD value decreased from 247.5 μm (minimum 80, maximum 745) at baseline to 0 μm (minimum 0, maximum 426) at the final examination (P < 0.001). No eyes lost vision at any control visit. The mean best corrected visual acuity increased from 0.89 ± 0.31 logMAR at baseline to 0.62 ± 0.31 logMAR at the final examination (P < 0.01). No local or systemic complication was observed.
In this case series, Ozurdex was found as a safe and effective treatment for SMD and ME associated with nonischemic CRVO.
评估玻璃体内注射地塞米松植入剂(Ozurdex)治疗非缺血性中央视网膜静脉阻塞(CRVO)患者浆液性黄斑脱离(SMD)的效果。
进行回顾性、介入性、非对照病例系列研究。研究对象为24例因非缺血性CRVO继发黄斑水肿(ME)和SMD的患者的24只眼。接受过玻璃体内注射曲安奈德和/或抗血管内皮生长因子治疗和/或接受过视网膜光凝治疗的患者被排除在研究之外。注射Ozurdex后,观察视力和解剖学反应。
平均随访时间为9.96±2.44个月(最短7个月,最长14个月)。注射Ozurdex后,除1例患者外,ME和SMD均消退。20例在平均5.45±1.43个月的时间内复发。其中17例有SMD。8例再次复发,1例在再次治疗后出现第三次复发。第二次复发的平均时间为5.50±1.19个月。在包括复发在内的所有随访检查中,SMD的高度均低于基线测量值。SMD的中位数从基线时的247.5μm(最小值80,最大值745)降至最终检查时的0μm(最小值0,最大值426)(P<0.001)。在任何一次对照访视中均无眼视力丧失。平均最佳矫正视力从基线时的0.89±0.31 logMAR提高到最终检查时的0.62±0.31 logMAR(P<0.01)。未观察到局部或全身并发症。
在本病例系列中,发现Ozurdex是治疗与非缺血性CRVO相关的SMD和ME的一种安全有效的方法。