Kang Eugene Yu-Chuan, Garg Sunir J, Chen Hsi-Fu, Wu Wei-Chi, Chen Linda Yi-Hsing, Chou Hung-Da, Liu Laura, Chen Kuan-Jen, Hwang Yih-Shiou
Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 333, Taiwan.
College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
J Clin Med. 2021 Aug 24;10(17):3762. doi: 10.3390/jcm10173762.
Macular edema (ME) is a common cause of visual loss among eyes with uveitis, and its management can be challenging. Steroids are an effective treatment for ME, and intravitreal dexamethasone (DEX) implants provide sustained steroid release. The purpose of this study is to evaluate intravitreal DEX implant on refractory ME in eyes with noninfectious uveitis. A retrospective study including 52 eyes of 37 patients with refractory uveitic ME was conducted from January 2011 through August 2017 at Linkou Chang Gung Memorial Hospital in Taiwan. Patients' demographic characteristics were collected. In addition, clinical information, including corrected visual acuity (VA), intraocular pressure (IOP), and central retinal thickness (CRT) on optical coherence tomography, was recorded and analyzed. During the study period, affected eyes received a total of 110 intravitreal DEX implants (range, one to six in each eye). After the first DEX implant injection in all eyes, VA significantly improved at one and two months. CRT significantly decreased one month after a single DEX implant, and the effect lasted for six months and waned over time. Patients receiving multiple DEX implants still showed significant decreases in CRT one month after the first implant. Increases in IOP were noted one month after the DEX implant, but the IOP could be medically controlled. Intravitreal DEX implants can effectively treat refractory uveitic ME, improving both VA and CRT with an acceptable safety profile. Further studies are necessary to evaluate the effect of multiple implants and long-term outcomes.
黄斑水肿（ME）是葡萄膜炎患者视力丧失的常见原因，其治疗具有挑战性。类固醇是治疗ME的有效方法，玻璃体内地塞米松（DEX）植入物可实现类固醇的持续释放。本研究的目的是评估玻璃体内DEX植入物对非感染性葡萄膜炎所致难治性ME的疗效。2011年1月至2017年8月，在台湾林口长庚纪念医院对37例难治性葡萄膜炎性ME患者的52只眼进行了一项回顾性研究。收集了患者的人口统计学特征。此外，还记录并分析了包括矫正视力（VA）、眼压（IOP）以及光学相干断层扫描测量的中心视网膜厚度（CRT）等临床信息。在研究期间，患眼共接受了110次玻璃体内DEX植入（每只眼植入1至6次）。所有患眼首次注射DEX植入物后，1个月和2个月时VA显著改善。单次注射DEX植入物1个月后CRT显著降低，且效果持续6个月，随后逐渐减弱。接受多次DEX植入的患者在首次植入后1个月时CRT仍显著降低。DEX植入物注射1个月后眼压升高，但眼压可通过药物控制。玻璃体内DEX植入物可有效治疗难治性葡萄膜炎性ME，改善VA和CRT，且安全性可接受。有必要进一步研究以评估多次植入的效果和长期预后。
