Udaondo Patricia, Hervas-Ontiveros Ana, Rosemblatt Amir, Garcia-Delpech Salvador
Ophthalmology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
Aiken Prevencción y Cirugía Ocular, Valencia, Spain.
Clin Ophthalmol. 2021 Oct 14;15:4153-4162. doi: 10.2147/OPTH.S336865. eCollection 2021.
To determine the impact of different baseline clinical characteristics on the improvement in best corrected visual acuity (BCVA) in patients with diabetic macular edema (DME) who underwent the intravitreal dexamethasone implant (DEX) Ozurdex.
This was a single center retrospective study conducted on patients with DME, either naïve or previously treated, who were treated with one or more DEX and had a follow-up of at least 6 months. The main outcome measure was the proportion of DEX achieving an improvement ≥15 letters in BCVA.
The study analyzed 192 DEX implants administered to 97 eyes (65 patients). Among the 192 DEX analyzed, 57 (29.7%) implants achieved a BCVA improvement ≥15 letters (ETDRS) from baseline, with a mean time for achieving such improvement of 89.2 (39.7) days. Eyes who received an additional DEX and those with a duration of DME < 6 months had a greater probability of achieving a BCVA improvement ≥15 letters (odds-ratio: 2.55, p = 0.0028 and odds-ratio: 1.93, p = 0.0434). The mean (standard deviation) change in BCVA from baseline was 7.5 (14.5) letters, p < 0.0001. The mean change in central macular thickness (CMT) from baseline was -128.0 (151.0) µm, p < 0.0001. The mean number of DEX implanted was 1.9 (0.8). Four (2.1%) DEX experienced an intraocular pressure increased ≥10 mm Hg; all the cases were successfully managed with topical antiglaucoma medication.
The results of this study confirmed previous evidence suggesting that DEX is effective for improving BCVA and CMT in patients with DME.
确定不同基线临床特征对接受玻璃体内地塞米松植入物（DEX）Ozurdex治疗的糖尿病性黄斑水肿（DME）患者最佳矫正视力（BCVA）改善情况的影响。
这是一项针对初治或曾接受治疗的DME患者进行的单中心回顾性研究，这些患者接受了一次或多次DEX治疗，且随访时间至少为6个月。主要结局指标是BCVA改善≥15个字母的DEX比例。
该研究分析了给97只眼（65例患者）植入的192枚DEX。在分析的192枚DEX中，57枚（29.7%）植入物使BCVA从基线改善≥15个字母（ETDRS），达到这种改善的平均时间为89.2（39.7）天。接受额外DEX的眼以及DME病程<6个月的眼实现BCVA改善≥15个字母的可能性更大（优势比：2.55，p = 0.0028；优势比：1.93 , p = 0.0434）。BCVA相对于基线的平均（标准差）变化为7.5（14.5）个字母，p < 0.0001。中心黄斑厚度（CMT）相对于基线的平均变化为 -128.0（151.0）µm，p < 0.0001。植入DEX的平均数量为1.9（0.8）枚。4枚（2.1%）DEX出现眼压升高≥10 mmHg；所有病例经局部抗青光眼药物治疗均成功控制。
本研究结果证实了先前的证据，表明DEX对改善DME患者的BCVA和CMT有效。
