Ahmed Muna, Putri Christine, Quhill Hibba, Quhill Fahd
Ophthalmology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, Yorkshire, UK.
BMJ Open Ophthalmol. 2020 Jul 5;5(1):e000484. doi: 10.1136/bmjophth-2020-000484. eCollection 2020.
To assess the real-world effectiveness and safety of single injection of a fluocinolone acetonide (FAc) implant in previously treated patients with recurrent diabetic macular oedema (DMO) over a 36-month follow-up period.
This is a retrospective study conducted at a single ophthalmology department at the Royal Hallamshire Hospital, Sheffield, UK. Data were collected using electronic medical records to identify all patients treated with a FAc implant for DMO between March 2014 and November 2014, followed with a 36-month clinic follow-up. Outcomes measured included mean change in best-recorded visual acuity (BRVA) and central macular thickness (CMT) over the period of 36 months, treatment burden pre-implant and post-implant, and functional and anatomical responder rates.
Twenty-six eyes (n=22 patients) were treated with single intravitreal FAc implant followed with 36 months of follow-up. At 24 and 36 months, 86.4% and 75.0% of patients maintained or gained vision post-FAc implant in routine clinical practice. The mean BRVA increased from 41.8 to 54.6 letters at month 24 and 45.8 letters at month 36, with 50.0% and 33.3% of patients achieving a ≥15 letter improvement at months 24 and 36, respectively. The mean CMT reduced from 600.8 µm at baseline to 351.0 µm and 392.5 µm at months 24 and 36, respectively. Overall, a mean of one treatment every 13.33 months post-FAc implant (vs 3.24 months pre-FAc implant) was reported. Eleven eyes had an increased intraocular pressure of ≥10 mm Hg and 12 eyes had an increase to ≥25 mm Hg from baseline.
These results further support the effectiveness and safety of FAc implant in previously treated patients with persistent or recurrent DMO in a real-world clinical practice.
评估单次注射曲安奈德(FAc)植入物在既往接受过治疗的复发性糖尿病性黄斑水肿(DMO)患者中36个月随访期内的真实世界有效性和安全性。
这是一项在英国谢菲尔德皇家哈勒姆郡医院的单一眼科科室进行的回顾性研究。通过电子病历收集数据,以确定2014年3月至2014年11月期间所有接受FAc植入物治疗DMO的患者,并进行36个月的门诊随访。测量的结果包括36个月期间最佳记录视力(BRVA)和中心黄斑厚度(CMT)的平均变化、植入前和植入后的治疗负担以及功能和解剖学反应率。
26只眼(n = 22例患者)接受了单次玻璃体内FAc植入物治疗,并进行了36个月的随访。在24个月和36个月时,在常规临床实践中,分别有86.4%和75.0%的患者在FAc植入后保持或提高了视力。BRVA的平均值在第24个月时从41.8提高到54.6个字母,在第36个月时提高到45.8个字母,分别有50.0%和33.3%的患者在第24个月和第36个月时视力提高≥15个字母。CMT的平均值从基线时的600.8µm分别降至第24个月和第36个月时的351.0µm和392.5µm。总体而言,据报告FAc植入后平均每13.33个月进行一次治疗(植入前为每3.24个月一次)。11只眼的眼压从基线升高≥10 mmHg,12只眼的眼压升高至≥25 mmHg。
这些结果进一步支持了在真实世界临床实践中,FAc植入物在既往接受过治疗的持续性或复发性DMO患者中的有效性和安全性。