Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Ophthalmic Practice Dr. Wecker, Heilbronn, Germany.
Sci Rep. 2021 Apr 15;11(1):8303. doi: 10.1038/s41598-021-87467-6.
Macular edema (ME) is the most frequent vision threatening consequence after retinal vein occlusion (RVO). In this study, we evaluate the effect of dexamethasone intravitreal implants (DII, Ozurdex) in a real-life cohort of 99 patients with ME due to RVO. All patients who received DII for ME following RVO between 2011 and 2016 at the University Eye Hospital Freiburg, Germany and who had fully accessible electronic medical records were eligible for this study. Most of the patients included in this study were not treatment-naïve: 61 eyes had received prior anti-VEGF drugs, 6 eyes had received intravitreal corticosteroids (triamcinolone) and 15 had been treated with both; 17 eyes were treatment-naïve. Mean follow-up was 312 ± 310 days. Mean visual acuity (VA) was maintained throughout the observation period (mean VA at baseline: 66.7 ± 23.5 letters; at last observation 64.9 ± 28.3). Central retinal thickness (CRT) decreased from 526 ± 179 µm at baseline to 431 ± 199 µm. Mean intraocular pressure (IOP) increased from 14.4 ± 3.1 mmHg at baseline to 17.1 ± 6.3 mmHg. Cataract surgery was performed in 22% of phakic eyes. DII was used as second-line treatment in the majority of cases in this cohort. The fact that mean VA remained unchanged while mean CRT decreased illustrates that morphologic improvement does not always translate into functional gain. Mean IOP was maintained within normal limits and cataract formation was as expected in this age group.
黄斑水肿(ME)是视网膜静脉阻塞(RVO)后最常见的威胁视力的后果。在这项研究中,我们评估了地塞米松玻璃体内植入物(DII,Ozurdex)在 99 例因 RVO 导致 ME 的患者中的实际效果。德国弗莱堡大学眼科医院于 2011 年至 2016 年间因 RVO 后 ME 接受 DII 治疗且可完全获取电子病历的所有患者均符合本研究条件。本研究纳入的大多数患者并非初次接受治疗:61 只眼曾接受过抗 VEGF 药物治疗,6 只眼曾接受过玻璃体内皮质类固醇(曲安奈德)治疗,15 只眼曾同时接受过两种药物治疗;17 只眼初次接受治疗。平均随访时间为 312±310 天。在整个观察期间,平均视力(VA)保持不变(基线时平均 VA:66.7±23.5 个字母;最后一次观察时为 64.9±28.3)。中央视网膜厚度(CRT)从基线时的 526±179µm 下降到 431±199µm。平均眼压(IOP)从基线时的 14.4±3.1mmHg 升高至 17.1±6.3mmHg。22%的有晶状体眼行白内障手术。在该队列中,DII 主要被用作二线治疗。VA 均值保持不变,而 CRT 均值降低,这表明形态学改善并不总是转化为功能增益。IOP 均值保持在正常范围内,该年龄组的白内障形成符合预期。