Özdemir Hüseyin Baran, Hasanreisoğlu Murat, Yüksel Murat, Ertop Mestan, Gürelik Gökhan, Özdek Şengül
Gazi University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey
Turk J Ophthalmol. 2019 Dec 31;49(6):323-327. doi: 10.4274/tjo.galenos.2019.95226.
To report the effectiveness and long-term outcomes of intravitreal dexamethasone implantation for diabetic macular edema (DME) in vitrectomized eyes.
Medical records of patients were retrospectively reviewed. Time of pars plana vitrectomy (PPV), PPV indications, interval between DEX injection and PPV, other intravitreal treatment prior to DEX application, best corrected visual acuity (BCVA), intraocular pressure (IOP), and central retinal thickness (CRT) measured by optical coherence tomography were recorded.
Seventeen eyes of 17 patients were included in the study. The mean follow-up after DEX injection was 21±2.4 months (12-43 months). The female/male ratio was 11/6. Mean age was 60.7 years (46-70 years). Sixteen eyes (94.1%) were pseudophakic at the time of DEX treatment. The most common indication for PPV was tractional retinal detachment (8 eyes, 47.1%). Ten eyes (58.8%) received a single injection and a total of 30 DEX implantations were performed. Mean BCVA was 0.77 logarithm of the minimum angle of resolution (logMAR) units before the first injection and improved to 0.64, 0.68 and 0.66 logMAR after 1, 3 and 6 months, respectively (p<0.01). CRT decreased significantly from 452 µm at baseline to 310, 368±34 and 375 µm after 1, 3 and 6 months, respectively (p<0.04). Mean IOP was 16±1.2 mmHg at baseline and 18.2, 18.8 and 18.5 mmHg after 1, 3, and 6 months (p>0.05). Two eyes (%8) received topical anti-glaucoma medication (IOP≥25 mmHg). Similar results were observed in eyes receiving repeated DEX injections.
Intravitreal DEX injection treatment seems to be effective for improving BCVA and decreasing CRT in vitrectomized eyes with DME. This effect seemed to last for 6 months in most eyes, but maximized at 3 months. Patients with repeated injections often require injection before 6 months.
报告玻璃体腔注射地塞米松植入物治疗玻璃体切除术后糖尿病性黄斑水肿（DME）的有效性及长期预后。
对患者的病历进行回顾性分析。记录玻璃体切割术（PPV）时间、PPV适应证、地塞米松（DEX）注射与PPV的间隔时间、DEX应用前的其他玻璃体腔治疗、最佳矫正视力（BCVA）、眼压（IOP）以及光学相干断层扫描测量的中心视网膜厚度（CRT）。
本研究纳入17例患者的17只眼。DEX注射后的平均随访时间为21±2.4个月（12 - 43个月）。男女比例为11/6。平均年龄为60.7岁（46 - 70岁）。16只眼（94.1%）在接受DEX治疗时为人工晶状体眼。PPV最常见的适应证是牵拉性视网膜脱离（8只眼，47.1%）。10只眼（58.8%）接受了单次注射，共进行了30次DEX植入。首次注射前平均BCVA为0.77最小分辨角对数（logMAR），1、3和6个月后分别提高到0.64、0.68和0.66 logMAR（p<0.01）。CRT从基线时的452 µm显著下降至1、3和6个月后的310、368±34和375 µm（p<0.04）。基线时平均IOP为16±1.2 mmHg, 1、3和6个月后分别为18.2、18.8和18.5 mmHg（p>0.05）。2只眼（8%）需要局部应用抗青光眼药物（IOP≥25 mmHg）。接受重复DEX注射的眼也观察到类似结果。
玻璃体腔注射DEX治疗似乎对改善玻璃体切除术后DME患眼的BCVA和降低CRT有效。这种效果在大多数眼中似乎持续6个月，但在3个月时达到最大。重复注射的患者通常需要在6个月前再次注射。
