Eibenberger Katharina, Schmetterer Leopold, Rezar-Dreindl Sandra, Wozniak Piotr, Told Reinhard, Mylonas Georgios, Krall Christoph, Schmidt-Erfurth Ursula, Sacu Stefan
Department of Ophthalmology, Medical University of Vienna, MUV, Vienna, Austria.
Department of Clinical Pharmacology, Medical University of Vienna, MUV, Vienna, Austria.
Invest Ophthalmol Vis Sci. 2017 Oct 1;58(12):5022-5029. doi: 10.1167/iovs.17-22229.
To investigate the effects of intravitreal 0.7 mg dexamethasone implants (Ozurdex) on arterial and venous oxygen saturation, retinal vessel diameter, and retrobulbar blood flow velocity in patients with macular edema (ME) due to retinal vein occlusion (RVO).
This prospective, nonrandomized clinical trial included 40 eyes of 40 patients with ME due to RVO. Measurements of arterial and venous oxygen saturation and retinal vessel diameters were performed using the Dynamic Vessel Analyzer. The main outcome measure was the retinal arteriovenous oxygen difference, calculated as the difference between arterial and venous oxygenation. Color Doppler imaging was performed for measuring peak systolic velocity (PSV), end diastolic velocity (EDV), and resistive index (RI) in ophthalmic artery (OA), central retinal artery (CRA), and posterior ciliary arteries (PCAs). Follow-up was monthly for 6 months following an initial dexamethasone implant injection. As statistical analysis, a mixed model was performed to investigate the effect treatment.
The arteriovenous oxygen difference showed a significant increase (P < 0.01). Arterial oxygenation and vessel diameter did not respond to the treatment (P > 0.05), while the venous oxygen saturation and diameter decreased significantly (P < 0.01) compared to baseline. The retrobulbar blood flow velocities PSV, EDV, and RI showed no change in the OA, CRA, and PCA (P > 0.05).
In patients with RVO, intravitreal dexamethasone treatment leads to an increase in arteriovenous oxygen saturation difference indicating improved retinal oxygenation. Arterial oxygenation and vessel diameter showed no response, whereas venous oxygenation and vessel diameter decreased after treatment.
研究玻璃体内注射0.7毫克地塞米松植入剂（Ozurdex）对视网膜静脉阻塞（RVO）所致黄斑水肿（ME）患者的动脉和静脉血氧饱和度、视网膜血管直径及球后血流速度的影响。
这项前瞻性、非随机临床试验纳入了40例因RVO导致ME的患者的40只眼。使用动态血管分析仪测量动脉和静脉血氧饱和度以及视网膜血管直径。主要观察指标是视网膜动静脉氧差，计算方法为动脉和静脉氧合之间的差值。采用彩色多普勒成像测量眼动脉（OA）、视网膜中央动脉（CRA）和睫状后动脉（PCA）的收缩期峰值速度（PSV）、舒张末期速度（EDV）和阻力指数（RI）。在首次注射地塞米松植入剂后进行为期6个月的每月随访。作为统计分析，采用混合模型研究治疗效果。
动静脉氧差显著增加（P < 0.01）。动脉氧合和血管直径对治疗无反应（P > 0.05），而静脉血氧饱和度和直径与基线相比显著降低（P < 0.01）。球后血流速度PSV、EDV和RI在OA、CRA和PCA中无变化（P > 0.05）。
在RVO患者中，玻璃体内注射地塞米松治疗导致动静脉血氧饱和度差增加，表明视网膜氧合改善。动脉氧合和血管直径无反应，而治疗后静脉氧合和血管直径降低。
