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玻璃体内双氯芬酸治疗难治性葡萄膜炎相关囊样黄斑水肿:前后临床研究。

Intravitreal diclofenac for treatment of refractory uveitis-associated cystoid macular oedema: A before and after clinical study.

机构信息

Department of Ophthalmology, Isfahan Eye Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Faculty of medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Acta Ophthalmol. 2018 May;96(3):e355-e360. doi: 10.1111/aos.13604. Epub 2018 Jan 25.

Abstract

BACKGROUND

Cystoid macular oedema (CME) is one of the important complications of uveitis leading to irreversible blindness. Currently, there is no gold standard treatment for this condition. The aim of this study was to investigate the effects of single intravitreal diclofenac (IVD) injection on short-term outcome of refractory uveitis-associated CME.

METHODS

This was a prospective clinical study on 16 consecutive patients (16 eyes) with refractory uveitis-associated CME. Intravitreal injection of 500 μg/0.1 ml of diclofenac sodium was given to the patients. The clinical outcomes considered were best-corrected visual acuity (BCVA) change and central macular thickness (CMT) changes in the pre- and postinjection periods. Follow-up examinations were performed at 1 and 4 weeks after the injection.

RESULTS

Age of the patients varied from 18 to 59 years (mean ± SD: 39.5 ± 13.2 years). Ten patients (62.5%) were females. Statistically significant differences were found in the decrease of mean BCVA (logMAR) (p = 0.043) and mean CMT (p = 0.003) during the study period. There was no significant difference in the intraocular pressure (IOP) increase at the end of the study (p = 0.94).

CONCLUSION

Intravitreal diclofenac (IVD) may be a promising treatment for refractory uveitis-associated CME. Further clinical trials with a larger sample size should be conducted to confirm these findings and compare them with other treatments.

摘要

背景

黄斑囊样水肿(CME)是葡萄膜炎导致不可逆性失明的重要并发症之一。目前,对于这种情况还没有金标准的治疗方法。本研究旨在探讨单次玻璃体内注射双氯芬酸钠(IVD)对难治性葡萄膜炎相关性 CME 短期疗效的影响。

方法

这是一项关于 16 例(16 只眼)难治性葡萄膜炎相关性 CME 患者的前瞻性临床研究。给予患者玻璃体内注射 500μg/0.1ml 双氯芬酸钠。考虑的临床结果是注射前后最佳矫正视力(BCVA)变化和中心黄斑厚度(CMT)变化。注射后 1 周和 4 周进行随访检查。

结果

患者年龄 18-59 岁(平均±SD:39.5±13.2 岁)。10 例(62.5%)为女性。研究期间,平均 BCVA(logMAR)(p=0.043)和平均 CMT(p=0.003)均显著下降。研究结束时,眼压(IOP)升高无显著差异(p=0.94)。

结论

玻璃体内注射双氯芬酸钠(IVD)可能是治疗难治性葡萄膜炎相关性 CME 的一种有前途的方法。应该进行更大样本量的临床试验来证实这些发现,并与其他治疗方法进行比较。

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