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玻璃体内注射地塞米松植入物(Ozurdex®)治疗伴有黄斑水肿的视网膜血管疾病的结果:真实情况的观察性研究。

Results of intravitreal dexamethasone implant (Ozurdex®) for retinal vascular diseases with macular edema: An observational study of real-life situations.

机构信息

Department of Ophthalmology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.

出版信息

Medicine (Baltimore). 2022 Jul 8;101(27):e29807. doi: 10.1097/MD.0000000000029807.

Abstract

To evaluate the efficacy of intravitreal dexamethasone implants (Ozurdex®) for the treatment of macular edema (ME) associated with retinal vascular diseases in real-life situations. This retrospective study included patients with ME associated with retinal vascular occlusion (RVO) or diabetic macular edema (DME) treated with dexamethasone implants. Demographic data, best-corrected visual acuity (BCVA), and central retinal thickness (CRT) at baseline and at 1, 3, and 6 months postoperatively were collected and analyzed, and the adverse events were recorded. Forty-four eyes, 42 patients were included in the study. The mean logMAR BCVA improved from 0.79 ± 0.38 at baseline to 0.60 ± 0.34 (P < 0.001), 0.72 ± 0.38 (P = .002), and 0.72 ± 0.37 (P = .002) at 1, 3, and 6 months, respectively. The CRT decreased from 526.70 ± 159.58 µm at baseline to 279 ± 66.23, 422.91 ± 206.99, and 350.23 ± 151.51 µm at 1, 3, and 6 months, respectively (P < 0.001, all visits). The average number of injections was 1.43 ± 0.5. Nineteen eyes (43.18%) received second injections at an interval of 4.20 ± 0.61 months. The mean logMAR BCVA was greater in RVO than in DME patients and in treatment-naïve eyes than in previously treated ones. The baseline CRT of the reinjection group was significantly higher than that of the single-injection group for both the RVO (P < 0.001) and DME groups (P = .002). Nine eyes (20.45%) with increasing intraocular pressure (IOP) were well controlled with medication, and cataract progression was observed in five eyes (21.73%) during follow-up. The dexamethasone implant was effective for the treatment of macular edema secondary to RVO and DME in terms of visual acuity and CRT improvement over 6 months. The visual acuity was greater in the RVO and treatment-naïve eyes. Reinjection may be associated with a high baseline CRT. The increase in the occurrence of IOP and cataract progression was similar to that reported in previous studies.

摘要

评估玻璃体内注射地塞米松植入物(Ozurdex®)治疗视网膜血管疾病相关黄斑水肿(ME)的疗效。本回顾性研究纳入了接受地塞米松植入物治疗的视网膜血管阻塞(RVO)或糖尿病性黄斑水肿(DME)相关 ME 的患者。收集并分析了患者的人口统计学数据、最佳矫正视力(BCVA)和基线及术后 1、3 和 6 个月的中心视网膜厚度(CRT),并记录了不良反应。本研究纳入了 44 只眼、42 例患者。平均 logMAR BCVA 从基线时的 0.79 ± 0.38 提高到了 0.60 ± 0.34(P < 0.001)、0.72 ± 0.38(P =.002)和 0.72 ± 0.37(P =.002),分别在术后 1、3 和 6 个月。CRT 从基线时的 526.70 ± 159.58 µm 降低到了 279 ± 66.23 µm、422.91 ± 206.99 µm 和 350.23 ± 151.51 µm,分别在术后 1、3 和 6 个月(均 P < 0.001)。平均注射次数为 1.43 ± 0.5。19 只眼(43.18%)在间隔 4.20 ± 0.61 个月时接受了第二次注射。RVO 患者的平均 logMAR BCVA 大于 DME 患者,初治患者的平均 logMAR BCVA 大于曾治疗患者。再次注射组的基线 CRT 高于单次注射组,无论是 RVO 组(P < 0.001)还是 DME 组(P =.002)。9 只眼(20.45%)的眼压(IOP)升高经药物治疗得到了良好控制,5 只眼(21.73%)在随访期间出现了白内障进展。地塞米松植入物在 6 个月内改善了视力和 CRT,对 RVO 和 DME 继发的黄斑水肿有效。RVO 和初治眼的视力较好。基线 CRT 较高的患者可能需要再次注射。IOP 和白内障进展发生率的增加与之前研究报道的相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5f4/9259138/7953ae526d83/medi-101-e29807-g001.jpg

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