Puerta de Hierro Majadahonda University Hospital, Madrid, Spain.
Bellvitge University Hospital, Barcelona, Spain.
Eur J Ophthalmol. 2021 May;31(3):1135-1145. doi: 10.1177/1120672120929960. Epub 2020 Jun 3.
To assess the functional and anatomical outcomes of intravitreal dexamethasone implant Ozurdex® in eyes with diabetic macular edema that did not adequately respond to vascular endothelial growth factor inhibitors.
Multicenter, retrospective, and real-life case series study conducted on consecutive diabetic macular edema patients who underwent treatment with one or more dexamethasone implant injections and were followed up for a minimum of 12 months. Subjects were divided into three groups: I-naïve patients, II-previously treated eyes that received three intravitreal antivascular endothelial growth factor inhibitors injections before the study (early switch), and III-previously treated eyes that received >3 intravitreal antivascular endothelial growth factor inhibitors injections before the study (late switch). Primary endpoints were best-corrected visual acuity and central retinal thickness at month 12.
A total of 129 eyes (21 naïve and 108 previously treated, Group II: 32 and Group III: 76) were included. At month 12, best-corrected visual acuity significantly improved from 0.27 ± 0.23 and 0.31 ± 0.22 at baseline to 0.36 ± 0.25 and 0.37 ± 0.23 at month 12 in naïve and previously treated eyes, respectively, and = 0.0063 and 0.0060, respectively. Central retinal thickness, in naïve and previously treated eyes, was significantly reduced from 483.0 ± 143.4 and 431.3 ± 115.5 µm, at baseline, to 278.8 ± 72.1 and 269.3 ± 66.2 µm, at month 12, respectively, and < 0.0001 each, respectively. Best-corrected visual acuity improvement was significantly greater in both absolute and percentage values, = 0.0393 and 0.0118, respectively, in Group II than in Group III.
In eyes with insufficient response to antivascular endothelial growth factor inhibitors, switching to dexamethasone at the time to 3-monthly antivascular endothelial growth factor inhibitors injections provided better functional outcomes than those that received >3 antivascular endothelial growth factor inhibitors injections.
评估玻璃体内注射地塞米松植入物 Ozurdex®对血管内皮生长因子抑制剂治疗反应不佳的糖尿病性黄斑水肿患者的功能和解剖学结果。
对连续接受一种或多种地塞米松植入物注射治疗并随访至少 12 个月的糖尿病性黄斑水肿患者进行了多中心、回顾性、真实病例系列研究。将患者分为三组：I-初治患者，II-研究前接受过 3 次玻璃体内抗血管内皮生长因子抑制剂注射的既往治疗眼（早期转换），III-研究前接受过 >3 次玻璃体内抗血管内皮生长因子抑制剂注射的既往治疗眼（晚期转换）。主要终点是治疗 12 个月时的最佳矫正视力和中心视网膜厚度。
共纳入 129 只眼（21 只初治和 108 只既往治疗眼，组 II：32 只，组 III：76 只）。在第 12 个月时，初治和既往治疗眼的最佳矫正视力分别从基线时的 0.27 ± 0.23 和 0.31 ± 0.22 显著提高至 0.36 ± 0.25 和 0.37 ± 0.23，=0.0063 和 0.0060。初治和既往治疗眼的中心视网膜厚度分别从基线时的 483.0 ± 143.4 和 431.3 ± 115.5 µm显著减少至治疗 12 个月时的 278.8 ± 72.1 和 269.3 ± 66.2 µm，=0.0001。初治组的最佳矫正视力改善无论是绝对值还是百分比都明显大于既往治疗组，=0.0393 和 0.0118。
在血管内皮生长因子抑制剂治疗反应不足的患者中，在转为每 3 个月注射血管内皮生长因子抑制剂时，转换为地塞米松的治疗方法提供了比接受 >3 次血管内皮生长因子抑制剂注射更好的功能结果。
