Alpay Atilla
Department of Ophthalmology, the School of Medicine, Zonguldak Bülent Ecevit University, Zonguldak 67600, Turkey.
Int J Ophthalmol. 2019 Aug 18;12(8):1298-1303. doi: 10.18240/ijo.2019.08.10. eCollection 2019.
To determine whether intravitreal dexamethasone (DEX) implant induces posterior vitreous detachment or not.
We retrospectively reviewed 810 eyes of 405 patients who underwent intravitreal DEX implantation due to macular edema caused by diabetic and retinal venous occlusion in our clinic. The eyes having no injection were determined as the control group. The examination findings of the patients before the injection and 3mo after the injection and optical coherence tomography (OCT) images were scanned. The pre-injection OCT findings and OCT findings of the patients having no posterior vitreous detachment (PVD) and determined to have partial PVD were compared.
The separation in vitreoretinal adhesion and total PVD development of DEX-injected 56/208 (26.9%) eyes were statistically greater in comparison with the 12/129 (9.3%) eyes that had not been injected (=0.001). PVD development was observed more in the patients that were younger, had larger macula thickness and lower visual acuity.
It can be stated that intravitreal DEX implant induces PVD development. Prospective, controlled studies are required in order to determine prognosis of vitreoretinal disease in PVD-developed patients and in non-PVD-developed patients.
确定玻璃体内注射地塞米松(DEX)植入物是否会诱发玻璃体后脱离。
我们回顾性分析了在我院因糖尿病性黄斑水肿和视网膜静脉阻塞接受玻璃体内DEX植入术的405例患者的810只眼。将未注射的眼作为对照组。扫描患者注射前和注射后3个月的检查结果及光学相干断层扫描(OCT)图像。比较未发生玻璃体后脱离(PVD)和确定为部分PVD患者的注射前OCT结果和OCT结果。
与未注射的12/129(9.3%)只眼相比,注射DEX的56/208(26.9%)只眼的玻璃体视网膜粘连分离和完全PVD发生率在统计学上更高(P=0.001)。在更年轻、黄斑厚度更大和视力更低的患者中观察到更多的PVD发生。
可以说玻璃体内DEX植入物会诱发PVD的发生。需要进行前瞻性对照研究,以确定发生PVD患者和未发生PVD患者的玻璃体视网膜疾病预后。