Chang Yo-Chen, Liu Pei-Kang, Kao Tzu-En, Wu Horng-Jiun, Cheng Kai-Chun, Chen Kuo-Jen, Wu Kwou-Yeung, Wu Wen-Chuan
Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan.
Department of Ophthalmology, School of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
J Ophthalmol. 2018 Dec 10;2018:5832186. doi: 10.1155/2018/5832186. eCollection 2018.
To investigate the functional and anatomical outcome of the 0.7 mg dexamethasone (Ozurdex) intravitreal implant (IVD) in eyes with long-term macular edema after macular epiretinal membrane removal.
We enrolled 40 eyes with persistent macular edema at least 12 months after epiretinal membrane removal. Twenty eyes in the IVD group received IVD and the other 20 eyes were in the control group. The main outcome measures were change in best-corrected visual acuity (BCVA) and central foveal thickness (CFT).
For eyes in the IVD group, the mean BCVA improved by 3.45 lines to 0.47 logMAR one month after IVD. However, the mean BCVA improved by only 0.14 lines to 0.74 logMAR at the same time in eyes in the control group. Six months later, the mean BCVA improved to 0.31 and 0.74 logMAR in the IVD and control groups, respectively. In the IVD group, the mean CFT decreased rapidly by 116.8 m to 333.9 m one month after IVD. Thereafter the CFT decreased at a slower pace. In the control group, the CFT remained static during the follow-up period. However, in the IVD group, 6 months after IVD, the CFT seemed to have a tendency to increase.
Single IVD could significantly decrease macular edema and improve visual outcome for eyes with persistent long-term macular edema after macular ERM removal and the effect can be sustained as long as 6 months after the initial injection. However, in order to maintain the visual and anatomical outcome, repeat IVD might be considered if macular edema recurs.
研究0.7毫克地塞米松(Ozurdex)玻璃体内植入物(IVD)对黄斑视网膜前膜切除术后长期黄斑水肿患者眼部的功能和解剖学转归。
我们纳入了40只在视网膜前膜切除术后至少12个月仍存在持续性黄斑水肿的眼睛。IVD组的20只眼睛接受了IVD治疗,另外20只眼睛作为对照组。主要观察指标为最佳矫正视力(BCVA)和中心凹厚度(CFT)的变化。
IVD组的眼睛在IVD治疗后1个月,平均BCVA提高了3.45行,至0.47 logMAR。然而,对照组的眼睛在同一时间平均BCVA仅提高了0.14行,至0.74 logMAR。6个月后,IVD组和对照组的平均BCVA分别提高到0.31和0.74 logMAR。在IVD组,IVD治疗后1个月,平均CFT迅速下降了116.8μm至333.9μm。此后CFT下降速度减慢。在对照组,随访期间CFT保持稳定。然而,在IVD组,IVD治疗6个月后,CFT似乎有增加的趋势。
单次IVD可显著减轻黄斑水肿,并改善黄斑视网膜前膜切除术后长期持续性黄斑水肿患者的视力转归,且该效果在初次注射后长达6个月内可持续。然而,为了维持视力和解剖学转归,如果黄斑水肿复发,可能需要考虑重复IVD治疗。