Huang Yu-Te, Lin Chun-Ju, Chen Huan-Sheng, Tien Peng-Tai, Lai Chun-Ting, Hsia Ning-Yi, Lin Jane-Ming, Chen Wen-Lu, Tsai Yi-Yu
Department of Ophthalmology, China Medical University Hospital, 2 Yuh-Der Road, Taichung City, Taiwan, 40447.
School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
BMC Ophthalmol. 2021 Mar 20;21(1):142. doi: 10.1186/s12886-021-01904-8.
This study evaluated the effects of dexamethasone intravitreal implant on treatment-naïve branch retinal vein occlusion (BRVO)-induced macular edema (ME), and the risk factors for earlier repeated treatment.
Patients treated from 2013 to 2016 were enrolled. The patients' demographics, medical history, best-corrected visual acuity (BCVA), and central retinal thickness (CRT) were recorded. Risk factors for repeated treatment were identified using a Cox proportional hazard model and logistic regression.
29 patients (mean age: 58.64 ± 13.3 years) were included; 44.8% received only one injection, while 55.2% received two or more. The mean initial CRT was 457.8 ± 167.1 μm; the peak CRT and final CRT improved significantly to 248.9 ± 57.9 μm and 329.2 ± 115.1 μm, respectively. The peak BCVA improvement and final improvement were 29.5 ± 23.5 approximate ETDRS letters and 19.8 ± 24.4 letters, respectively, with 62.1% of patients improving by more than 15 letters. Older age, higher initial CRT, and diabetes were the risk factors for multiple injections.
Dexamethasone intravitreal implant results in significant peak CRT and BCVA improvements, while older age, higher initial CRT, and diabetes are risk factors for repeated injections. The optimal retreatment schedule for these patients should be further explored.
本研究评估了玻璃体内注射地塞米松植入物对初治视网膜分支静脉阻塞（BRVO）所致黄斑水肿（ME）的治疗效果，以及早期重复治疗的危险因素。
纳入2013年至2016年接受治疗的患者。记录患者的人口统计学资料、病史、最佳矫正视力（BCVA）和中心视网膜厚度（CRT）。使用Cox比例风险模型和逻辑回归确定重复治疗的危险因素。
纳入29例患者（平均年龄：58.64±13.3岁）；44.8%的患者仅接受了一次注射，而55.2%的患者接受了两次或更多次注射。初始平均CRT为457.8±167.1μm；峰值CRT和最终CRT分别显著改善至248.9±57.9μm和329.2±115.1μm。BCVA的峰值改善和最终改善分别为29.5±23.5个近似ETDRS字母和19.8±24.4个字母，62.1%的患者改善超过15个字母。年龄较大、初始CRT较高和患有糖尿病是多次注射的危险因素。
玻璃体内注射地塞米松植入物可使CRT峰值和BCVA显著改善，而年龄较大、初始CRT较高和患有糖尿病是重复注射的危险因素。应进一步探索这些患者的最佳再治疗方案。
