Sharma Ashish, Bellala Keerthi, Dongre Pankaj, Reddy Prahalad
Department of Vitreoretina, Lotus Eye Hospital, and Institute, Avinashi Road, Coimbatore, TN, 641014, India.
Department of Retina and Vitreous Surgery, L V Prasad Eye Institute, GMRV Campus, Visakhapatnam, Andhra Pradesh, India.
Int Ophthalmol. 2020 Jan;40(1):67-72. doi: 10.1007/s10792-019-01151-3. Epub 2019 Aug 3.
To compare the efficacy and safety of intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection versus dexamethasone implant (Ozurdex) for the treatment of center-involved DME (CiDME).
This prospective randomized comparative study included 40 eyes (38 patients) of CiDME. They were randomized into two groups. Patients in group A received the intravitreal anti-VEGF injection (bevacizumab 1.25 mg or ranibizumab 0.5 mg) and those in group B received dexamethasone implant (0.7 mg) pro-re-nata after 4 weeks and 3 months, respectively. The primary outcome was measured at 3 months from the baseline that included improvement in BCVA, reduction in CFT, and adverse effects during the follow-up period.
Mean best-corrected visual acuity (BCVA) improved from 0.51 ± 0.275 LogMAR units (20/63) to 0.20 ± 0.185 LogMAR units (20/32) in group A and from 0.56 ± 0.213 LogMAR units (20/80) to 0.141 ± 0.177 LogMAR units (20/32) in group B at 3 months. There was no significant difference in mean BCVA between both the groups (p = .27). The mean central foveal thickness (CFT) improved from 443.55 ± 131.536 µ to 277.66 ± 76.184 µ and from 460.95 ± 125.462 µ to 233.25 ± 37.552 µ at 3 months in group B (p = .02).
Both the groups had the similar visual outcome. However, the superior anatomical result was observed in dexamethasone implant group during this short follow-up.
比较玻璃体内注射抗血管内皮生长因子(抗VEGF)与地塞米松植入物(Ozurdex)治疗累及黄斑中心凹糖尿病性黄斑水肿(CiDME)的疗效和安全性。
这项前瞻性随机对照研究纳入了40只CiDME患眼(38例患者)。将他们随机分为两组。A组患者接受玻璃体内抗VEGF注射(贝伐单抗1.25mg或雷珠单抗0.5mg),B组患者分别在4周和3个月后按需接受地塞米松植入物(0.7mg)。主要结局指标在基线后3个月进行测量,包括最佳矫正视力(BCVA)的改善、中心凹视网膜厚度(CFT)的降低以及随访期间的不良反应。
3个月时,A组平均最佳矫正视力(BCVA)从0.51±0.275 LogMAR单位(20/63)提高到0.20±0.185 LogMAR单位(20/32),B组从0.56±0.213 LogMAR单位(20/80)提高到0.141±0.177 LogMAR单位(20/32)。两组间平均BCVA无显著差异(p = 0.27)。3个月时,B组平均中心凹视网膜厚度(CFT)从443.55±131.536µm改善至277.66±76.184µm,从460.95±125.462µm改善至233.25±37.552µm(p = (此处原文似乎有误,推测应为p = 0.02))。
两组视力结局相似。然而,在此次短期随访中,地塞米松植入物组观察到更优的解剖学结果。