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局部应用干扰素α-2b治疗难治性糖尿病性黄斑水肿。

Topical Interferon Alpha 2b in the Treatment of Refractory Diabetic Macular Edema.

作者信息

Maleki Arash, Stephenson Andrew Phillips, Hajizadeh Fedra

机构信息

Ocular Immunology and Uveitis Foundation, Waltham, MA, USA.

Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran.

出版信息

J Ophthalmic Vis Res. 2020 Oct 25;15(4):453-458. doi: 10.18502/jovr.v15i4.7785. eCollection 2020 Oct-Dec.

DOI:10.18502/jovr.v15i4.7785
PMID:33133435
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7591848/
Abstract

PURPOSE

To report the efficacy of topical interferon alpha 2b in the treatment of refractory diabetic macular edema.

METHODS

In this retrospective interventional case series, five eyes of three individuals with diabetic macular edema resistant to multiple intravitreal injections of anti-vascular endothelial growth factor drugs and macular photocoagulation were included.

RESULTS

All studied eyes had undergone multiple intravitreal injections including bevacizumab, combination of bevacizumab and triamcinolone and aflibercept, and macular laser photocoagulation before being included in this study. Two intravitreal ranibizumab injections had also been performed in both eyes of one patient. Two eyes had undergone pars plana vitrectomy, one for diabetic macular edema and the other for rhegmatogenous retinal detachment. After a discussion regarding the experimental topical interferon alpha 2b treatment, all patients agreed to start interferon alpha 2b drops four times a day. One month after the treatment, optical coherence tomography demonstrated a significant improvement in macular structure and thickness which was stable or improved at the three-month follow-up visit. Visual acuity in all eyes was stable or improved throughout the three-month follow-up period. Conjunctival injection and follicular conjunctivitis were the side effects of topical interferon alpha 2b and were treated with lubrication and steroids.

CONCLUSION

This case series demonstrated the potential efficacy of interferon alpha 2b in the treatment of refractory diabetic macular edema. It might be an option in patients with contraindications for intravitreal injections.

摘要

目的

报告局部应用干扰素α-2b治疗难治性糖尿病性黄斑水肿的疗效。

方法

在这个回顾性介入病例系列中，纳入了3例糖尿病性黄斑水肿患者的5只眼，这些患者对多次玻璃体内注射抗血管内皮生长因子药物及黄斑光凝治疗均耐药。

结果

所有研究眼在纳入本研究之前均已接受多次玻璃体内注射，包括贝伐单抗、贝伐单抗与曲安奈德联合应用以及阿柏西普，并且接受了黄斑激光光凝治疗。1例患者的双眼还接受了2次玻璃体内注射雷珠单抗。2只眼接受了玻璃体切除术，其中1只眼是因糖尿病性黄斑水肿，另1只眼是因孔源性视网膜脱离。在讨论了实验性局部应用干扰素α-2b治疗后，所有患者均同意开始每天4次滴用干扰素α-2b。治疗1个月后，光学相干断层扫描显示黄斑结构和厚度有显著改善，在3个月的随访期内保持稳定或有所改善。在整个3个月的随访期内，所有眼的视力均保持稳定或有所提高。结膜注射和滤泡性结膜炎是局部应用干扰素α-2b的副作用，通过润滑和使用类固醇进行治疗。

结论

这个病例系列证明了干扰素α-2b在治疗难治性糖尿病性黄斑水肿方面的潜在疗效。对于有玻璃体内注射禁忌证的患者，它可能是一种选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8093/7591848/a33c603e4b89/jovr-15-453-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8093/7591848/711d7b8ad07b/jovr-15-453-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8093/7591848/ab98b5f5a99c/jovr-15-453-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8093/7591848/a33c603e4b89/jovr-15-453-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8093/7591848/711d7b8ad07b/jovr-15-453-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8093/7591848/ab98b5f5a99c/jovr-15-453-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8093/7591848/a33c603e4b89/jovr-15-453-g003.jpg

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