Saint Louis University School of Medicine, St. Louis, Missouri.
The Retina Institute of Saint Louis, St. Louis, Missouri; and.
Retin Cases Brief Rep. 2022 Jul 1;16(4):461-465. doi: 10.1097/ICB.0000000000001008. Epub 2020 Jul 7.
BACKGROUND/PURPOSE: To report a case of bilateral diffuse uveal melanocytic proliferation (BDUMP) treated with intravitreal steroid implants.
Bilateral diffuse uveal melanocytic proliferation was diagnosed and treated with intravitreal steroid implants (both dexamethasone 0.7 mg [intravitreal dexamethasone implants] and fluocinolone acetonide 0.18 mg [intravitreal fluocinolone acetonide implants]) and monitored every 2 weeks to 4 weeks with optical coherence tomography.
Intravitreal dexamethasone implants improved visual acuity and central retinal thickness for 10 weeks, was best from 4 to 6 weeks, and recurred by 14 weeks after treatment. Intravitreal fluocinolone acetonide implants improved visual acuity and central retinal thickness for 20 weeks after treatment without edema recurrence. No retinal detachments were observed over 1 year of treatment.
Intravitreal steroid implants resulted in visual acuity improvement and central retinal thickness reduction for up to 20 weeks and may protect against retinal detachments in patients with bilateral diffuse uveal melanocytic proliferation.
背景/目的：报告一例接受玻璃体内皮质类固醇植入物治疗的双侧弥漫性葡萄膜黑色素细胞增生（BDUMP）。
诊断为双侧弥漫性葡萄膜黑色素细胞增生，并采用玻璃体内皮质类固醇植入物（均为地塞米松 0.7 mg [玻璃体内地塞米松植入物]和氟轻松醋酸酯 0.18 mg [玻璃体内氟轻松醋酸酯植入物]）进行治疗，并每隔 2 至 4 周使用光学相干断层扫描进行监测。
玻璃体内地塞米松植入物在 10 周内改善了视力和中心视网膜厚度，在 4 至 6 周时效果最佳，在治疗后 14 周时再次出现。玻璃体内氟轻松醋酸酯植入物在治疗后 20 周内改善了视力和中心视网膜厚度，且无水肿复发。在 1 年的治疗期间未观察到视网膜脱离。
玻璃体内皮质类固醇植入物可使视力提高和中心视网膜厚度降低长达 20 周，并可能预防双侧弥漫性葡萄膜黑色素细胞增生患者的视网膜脱离。
