Service d'Ophtalmologie, Hôpital Universitaire de la Croix-Rousse, Hospices Civils de Lyon, Université Lyon 1, Lyon, France.
Laboratoire UMR-CNRS 5510 Matéis, Université Lyon 1, Villeurbane, France.
Retina. 2021 Mar 1;41(3):620-629. doi: 10.1097/IAE.0000000000002901.
To evaluate the real-life efficacy and safety of the intravitreal dexamethasone implant in uveitis.
This retrospective observational multicentric study included 152 eyes treated exclusively by 358 dexamethasone implant injections. The main outcome measures included change in the best-corrected visual acuity, central macular thickness, and vitreous haze score.
Patients were treated with dexamethasone implant for macular edema (51.3%), vitritis with macular edema (40.1%), vitritis (5.3%), and other causes (3.3%). The mean duration of follow-up was 19.0 months. The mean gain in best-corrected visual acuity during follow-up was +12.1 letters. An improvement in best-corrected visual acuity ≥5, 10, and 15 letters was found in 64.5, 50.7, and 35.5% of cases, respectively. 59.7% of eyes with macular edema at baseline were found to be anatomical responders. Vitritis resolution (vitreous haze = 0+) was obtained in 81.4% of cases. Ocular hypertension (intraocular pressure ≥25 mmHg and/or gain ≥10 mmHg from baseline) occurred in 28.3% of patients. No filtering surgery/laser therapy was required. A total of 40.2% of phakic subjects underwent cataract surgery on average 11.2 months after the first injection.
This study confirms the efficacy and safety of the dexamethasone implant in noninfectious uveitis. Cataract and ocular hypertension were not uncommon but easily manageable.
评估玻璃体内注射地塞米松植入物治疗葡萄膜炎的真实疗效和安全性。
这是一项回顾性多中心研究,共纳入 152 只眼,均单独接受 358 次地塞米松植入物治疗。主要观察指标包括最佳矫正视力、中心黄斑厚度和玻璃体混浊评分的变化。
患者因黄斑水肿(51.3%)、合并黄斑水肿的葡萄膜炎(40.1%)、单纯葡萄膜炎(5.3%)和其他原因(3.3%)接受地塞米松植入物治疗。平均随访时间为 19.0 个月。随访期间平均最佳矫正视力提高了+12.1 个字母。64.5%、50.7%和 35.5%的病例最佳矫正视力提高≥5、10 和 15 个字母。基线时有黄斑水肿的 59.7%的眼为解剖学应答者。81.4%的病例炎症得到缓解(玻璃体混浊=0+)。28.3%的患者发生眼内压升高(眼压≥25mmHg 或与基线相比升高≥10mmHg)。无需行滤过性手术/激光治疗。平均在第 1 次注射后 11.2 个月,40.2%的有晶状体眼患者接受了白内障手术。
本研究证实了玻璃体内注射地塞米松植入物治疗非感染性葡萄膜炎的疗效和安全性。白内障和眼内压升高虽不常见,但易于处理。