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玻璃体内注射地塞米松植入物治疗视网膜静脉阻塞所致黄斑水肿后的短期疗效预后因素

Short-term effectiveness prognostic factors after dexamethasone intravitreal implant in macular edema due to retinal vein occlusion.

作者信息

Garay-Aramburu Gonzaga, Gómez-Moreno Ángela, Urcola Aritz

机构信息

Ophthalmology Department, Basurto University Hospital, Bilbao, Spain.

Universidad del Pais Vasco-Euskal Herriko Unibertsitatea, Vitoria-Gasteiz, Spain.

出版信息

Eur J Ophthalmol. 2022 May;32(3):1671-1679. doi: 10.1177/11206721211032520. Epub 2021 Jul 13.

Abstract

INTRODUCTION

The aim of this study was to describe functional and anatomical changes (best-corrected visual acuity [BCVA], central macular thickness [CMT], and central macular volume [CMV]) in patients with macular edema (ME) secondary to retinal vein occlusion (RVO) treated with intravitreal dexamethasone implant (IDI) and identify its clinical predictors in a real-world setting.

METHODS

Data from 111 patients who underwent IDI to treat RVO-associated ME were retrospectively reviewed. Demographic, preoperative, and postoperative variables were assessed using a logistic regression analysis to determine predictors of visual and anatomical improvement.

RESULTS

Mean BCVA, CMT, and CMV improved from baseline after IDI ( < 0.001). The strongest predictors of different treatment outcomes were: a baseline BCVA ⩽60 ETDRS letters (OR = 50.600;  < 0.001) and first IDI injection (OR = 2.988;  < 0.001) for BCVA gain ⩾15 Early Treatment Diabetic Retinopathy Study (ETDRS) letters; a baseline BCVA ⩽60 ETDRS letters (OR = 7.893;  = 0.002) and non-chronic ME (OR = 3.875;  = 0.019) for BCVA ⩾80 ETDRS letters achievement; a baseline CMT ⩾400 µm (OR = 49.083;   0.001) and a baseline CMV ⩾12 mm (OR = 4.235;  < 0.001) for CMT reduction ⩾50%; and a baseline CMT ⩾400 µm (OR = 11.471;   0.001) and a baseline CMV ⩾12 mm (OR = 10.284;  < 0.001) for CMV reduction ⩾15%.

CONCLUSION

This study confirmed the effectiveness of IDI to treat ME secondary to RVO and identified new predictive factors for two visual (⩾15 ETDRS letters gain and BCVA ⩾80 ETDRS letters) and two anatomical outcomes (>50% CMT and >15% CMV reduction).

摘要

引言

本研究的目的是描述玻璃体内地塞米松植入物(IDI)治疗视网膜静脉阻塞(RVO)继发黄斑水肿(ME)患者的功能和解剖学变化(最佳矫正视力[BCVA]、中心黄斑厚度[CMT]和中心黄斑体积[CMV]),并在现实环境中确定其临床预测因素。

方法

回顾性分析111例行IDI治疗RVO相关ME患者的数据。使用逻辑回归分析评估人口统计学、术前和术后变量,以确定视力和解剖学改善的预测因素。

结果

IDI治疗后,平均BCVA、CMT和CMV较基线水平有所改善(<0.001)。不同治疗结果的最强预测因素为:BCVA提高≥15早期糖尿病视网膜病变研究(ETDRS)字母,基线BCVA≤60 ETDRS字母(OR=50.600;<0.001)和首次IDI注射(OR=2.988;<0.001);BCVA≥80 ETDRS字母,基线BCVA≤60 ETDRS字母(OR=7.893;=0.002)和非慢性ME(OR=3.875;=0.019);CMT降低≥50%,基线CMT≥400 µm(OR=49.083;<0.001)和基线CMV≥12 mm(OR=4.235;<0.001);CMV降低≥15%,基线CMT≥400 µm(OR=11.471;<0.001)和基线CMV≥12 mm(OR=10.284;<0.001)。

结论

本研究证实了IDI治疗RVO继发ME的有效性,并确定了两种视力结果(提高≥15 ETDRS字母和BCVA≥80 ETDRS字母)和两种解剖学结果(CMT降低>50%和CMV降低>15%)的新预测因素。

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