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玻璃体内注射地塞米松治疗黄斑水肿和葡萄膜炎:一项全面的叙述性综述

Dexamethasone Intravitreal Implant for the Treatment of Macular Edema and Uveitis: A Comprehensive Narrative Review.

作者信息

Kishore Kamal, Bhat Pooja V, Venkatesh Pradeep, Canizela Cecilia C

机构信息

Illinois Retina and Eye Associates, Peoria, IL, USA.

Department of Surgery, University of Illinois College of Medicine, Peoria, IL, USA.

出版信息

Clin Ophthalmol. 2022 Apr 6;16:1019-1045. doi: 10.2147/OPTH.S209395. eCollection 2022.

Abstract

PURPOSE

The purpose of this review article is to provide a comprehensive review of the current applications of intravitreal DEX implant (Ozurdex, Allergan Inc, Irvine, CA) for a variety of ophthalmic conditions - ranging from FDA approved indications to off-label uses. We have attempted to provide relevant evidence from the literature to help a reader develop an understanding of the biological and pharmacokinetic properties of DEX implant, its uses, and potential side effects.

METHODS

PubMed searches were performed using the terms "Ozurdex", or "intravitreal DEX implant", AND "retinal vein occlusion", or "diabetic macular edema", or "uveitis". The search was performed in July of 2021, with an additional search in October 2021. All original English language articles were considered for this review.

RESULTS

DEX implant has evidence of efficacy in a variety of clinical situations including macular edema associated with retinal vein occlusion, diabetes, uveitis, and others. Safety concerns include cataract formation and progression, intraocular pressure elevation, complications related to intravitreal injection, and opportunistic infections secondary to steroid-induced immune suppression.

CONCLUSION

DEX implant is a useful tool in the management of several retinal disorders. Further studies are needed for head-to-head comparison with other treatment modalities and to determine its precise place in clinical practice.

摘要

目的

本综述文章旨在全面回顾玻璃体内地塞米松植入剂(Ozurdex,艾尔建公司,加利福尼亚州欧文市)在多种眼科疾病中的当前应用——从美国食品药品监督管理局(FDA)批准的适应症到非标签用途。我们试图从文献中提供相关证据,以帮助读者了解地塞米松植入剂的生物学和药代动力学特性、其用途及潜在副作用。

方法

使用术语“Ozurdex”或“玻璃体内地塞米松植入剂”以及“视网膜静脉阻塞”或“糖尿病性黄斑水肿”或“葡萄膜炎”在PubMed上进行检索。检索于2021年7月进行,并在2021年10月进行了额外检索。本次综述考虑了所有英文原文文章。

结果

地塞米松植入剂在多种临床情况中具有疗效证据,包括与视网膜静脉阻塞、糖尿病、葡萄膜炎等相关的黄斑水肿。安全问题包括白内障形成和进展、眼压升高、与玻璃体内注射相关的并发症以及类固醇诱导的免疫抑制继发的机会性感染。

结论

地塞米松植入剂是管理多种视网膜疾病的有用工具。需要进一步研究以与其他治疗方式进行直接比较,并确定其在临床实践中的精确地位。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7798/8995179/fd024f2c36d9/OPTH-16-1019-g0001.jpg

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