Hospital Provincial de Castellón, Castellón, Spain.
Hospital Comarcal de Vinaròs, Castellón, Spain.
Curr Med Res Opin. 2019 Dec;35(12):2111-2116. doi: 10.1080/03007995.2019.1652449. Epub 2019 Sep 19.
To evaluate the mid-long-term efficacy and safety of the dexamethasone intravitreal (DEX) implant (Ozurdex) in naïve patients with diabetic macular edema (DME). Prospective and single-center study conducted on consecutive patients with a diagnosis of DME, who received a DEX implant and were followed up for at least 12 months. The main outcomes measurements were the mean change in best corrected visual acuity (BCVA) and in foveal thickness (FT) as compared to the baseline values. Of the 84 screened patients 50 were included in the study. The BCVA significantly improved from 52.4 (20.4) letters at baseline to 62.6 (15.6), 61.2 (18.4), 61.6 (18.6), 60.6 (19.0), and 60.6 (18.8) at 2, 4, 6, 12 months and end of follow-up period, respectively (repeated measures ANOVA and the Greenhouse-Geisser correction; .0008). At the end of the follow-up period, a gain of BCVA of ≥5, ≥10, and ≥15 letters were observed in 26 (52.0%), 18 (36.0%), and 16 (32.0%) patients, respectively. The mean FT was significantly reduced from 446.0 (139.9) µm at baseline to 327.2 (103.6) at the end of follow-up (repeated measures ANOVA and the Greenhouse-Geisser correction; .0008). During the study follow-up, the patients receive a mean of 3.4 (2.9-3.9) implants. Of the 32 phakic eyes at baseline, 17 (53.1%) either developed new lens opacity or progression of an existing opacity. In eyes with DME not previously treated with intravitreal drugs, DEX implants provide meaningful functional and anatomical benefits, and these results are sustained mid-long-term.
评估初治糖尿病黄斑水肿(DME)患者应用地塞米松玻璃体植入剂(Ozurdex)的中-长期疗效和安全性。该前瞻性、单中心研究纳入了经诊断为 DME 并接受地塞米松玻璃体植入剂治疗且至少随访 12 个月的连续患者。主要观察终点为与基线相比最佳矫正视力(BCVA)和中心凹视网膜厚度(FT)的平均变化。在筛选的 84 例患者中,有 50 例纳入研究。BCVA 从基线时的 52.4(20.4)个字母显著改善至治疗后 2、4、6、12 个月及随访期末的 62.6(15.6)、61.2(18.4)、61.6(18.6)、60.6(19.0)和 60.6(18.8)(重复测量方差分析和 Greenhouse-Geisser 校正; .0008)。在随访期末,26 例(52.0%)、18 例(36.0%)和 16 例(32.0%)患者的 BCVA 分别增加≥5、≥10 和≥15 个字母。FT 从基线时的 446.0(139.9)µm 显著降低至随访期末的 327.2(103.6)µm(重复测量方差分析和 Greenhouse-Geisser 校正; .0008)。在研究随访期间,患者平均接受 3.4(2.9-3.9)次植入。在基线时有 32 例非白内障眼,其中 17 例(53.1%)发生新的晶状体混浊或已存在的混浊进展。在未接受过玻璃体内药物治疗的 DME 眼中,地塞米松玻璃体植入剂可提供有意义的功能和解剖学改善,这些结果可在中-长期持续。