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地塞米松植入物治疗视网膜静脉阻塞所致黄斑水肿的长期视力结果及其预测因素。

Long-term visual outcome and its predictors in macular oedema secondary to retinal vein occlusion treated with dexamethasone implant.

机构信息

Department of Ophthalmology, University Hospital Leipzig, Leipzig, Germany.

Banker's Retina Clinic & Laser Center, Ahmedabad, India.

出版信息

Br J Ophthalmol. 2019 Apr;103(4):463-468. doi: 10.1136/bjophthalmol-2017-311805. Epub 2018 Jun 11.

DOI:10.1136/bjophthalmol-2017-311805
PMID:29891733
Abstract

BACKGROUND

To evaluate the functional long-term outcome in patients with macular oedema (MO) secondary to central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO) treated with dexamethasone implant (DEX implant) and to identify its clinical predictors.

METHODS

A 24-month, retrospective, multinational, real-world study. Chart review of patients with either naïve or recurrent MO secondary to CRVO/BRVO treated with DEX implant, including best-corrected visual acuity (BCVA), central subfield thickness (CST), demographic baseline characteristics and details of any additional treatment during follow-up.

RESULTS

A total of 155 eyes (65 CRVO, 90 BRVO) from 155 patients were included. At 24 months, mean BCVA did not change significantly in CRVO (-2.1±24.5 letters, p=0.96) and BRVO patients (1.3±27.0 letters, p=0.07). A worse baseline BCVA (p<0.001), visual acuity (VA) gain ≥5 letters at 2 months (p=0.006) and no need for adjunctive intravitreal therapy after first DEX implant (p=0.001) were associated with a better final BCVA gain. Treatment-naïve patients (p=0.006, OR: 0.25, 95% CI 0.11 to 0.57) and those with a baseline CST≤400 µm (p=0.02, OR: 0.25, 95% CI 0.10 to 0.63) were identified as being less likely to need additional intravitreal therapy.

CONCLUSION

Clinical baseline characteristics and the early treatment response were identified as possible predictors for long-term outcome and the need of adjunctive intravitreal therapy in MO secondary to BRVO/CRVO treated by DEX implant.

摘要

背景

评估接受地塞米松植入物(DEX 植入物)治疗的中心性视网膜静脉阻塞(CRVO)和分支视网膜静脉阻塞(BRVO)继发黄斑水肿(MO)患者的功能长期预后,并确定其临床预测因素。

方法

这是一项为期 24 个月的回顾性、多国、真实世界研究。对接受 DEX 植入物治疗的初次或复发 MO 的 CRVO/BRVO 患者的病历进行回顾,包括最佳矫正视力(BCVA)、中央视网膜厚度(CST)、人口统计学基线特征和随访期间任何额外治疗的详细信息。

结果

共纳入 155 名患者的 155 只眼(65 只 CRVO,90 只 BRVO)。24 个月时,CRVO 患者(-2.1±24.5 个字母,p=0.96)和 BRVO 患者(1.3±27.0 个字母,p=0.07)的平均 BCVA 无显著变化。基线 BCVA 较差(p<0.001)、治疗后 2 个月视力提高≥5 个字母(p=0.006)和首次 DEX 植入后无需辅助玻璃体内治疗(p=0.001)与最终 BCVA 提高相关。初次治疗患者(p=0.006,OR:0.25,95%CI 0.11 至 0.57)和基线 CST≤400µm 的患者(p=0.02,OR:0.25,95%CI 0.10 至 0.63)不太可能需要额外的玻璃体内治疗。

结论

BRVO/CRVO 继发 MO 患者接受 DEX 植入物治疗后的临床基线特征和早期治疗反应被确定为长期预后和辅助玻璃体内治疗需求的可能预测因素。

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