Ophthalmology Department, Gaziantep Dr. Ersin Aslan Training and Research Hospital, Gaziantep, Turkey.
Ophthalmology Department, University of Health Sciences, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey.
Ophthalmologica. 2022;245(5):439-445. doi: 10.1159/000526172. Epub 2022 Aug 3.
The aim of this study was to compare posterior subtenon triamcinolone (PSTA) application and intravitreal dexamethasone phosphate (DEX) implant in the treatment of diabetic macular edema (DME) in vitrectomized eyes.
This retrospective study included 64 (48.12%) patients who received PSTA and 69 (51.88%) patients who received DEX implants in DME treatment after vitrectomy. Best corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) were analyzed before injection; at 1, 3, and 6 months after injection. The postinjection values were statistically compared with the preinjection value.
All postinjection CMT values in both groups were lower than the preinjection value (p < 0.05 for all). There were statistically significant increases in all postinjection BCVAs of the DEX group and postinjection 1-month BCVA of the PSTA group (p < 0.05 for all). However, there was no significant difference in BCVA values of the PSTA group at 3 and 6 months after injection (p > 0.05 for both). There was no statistically significant difference in all postinjection IOP values of the PSTA group (p > 0.05 for all). However, significant increases in IOP were observed in the DEX group at 1 and 3 months after injection (p < 0.05 and p = 0.02, respectively). The number of additional injections between the 3rd and 6th months after the initial injection was statistically higher in the PSTA group (p = 0.006).
Both intravitreal DEX and PSTA administration are effective in the treatment of DME after vitrectomy. However, visual improvement persisted longer, and the need for additional injections was less in patients who received DEX.
本研究旨在比较玻璃体内曲安奈德(DEX)植入与玻璃体内后Tenon 囊下曲安奈德(PSTA)注射治疗玻璃体切除术后糖尿病性黄斑水肿(DME)的疗效。
本回顾性研究纳入 64 例(48.12%)接受 PSTA 治疗和 69 例(51.88%)接受 DEX 植入治疗的 DME 患者。分析两组患者治疗前后最佳矫正视力(BCVA)、黄斑中心视网膜厚度(CMT)和眼压(IOP)。比较两组患者注射后 1、3、6 个月的注射后值与注射前值。
两组患者的所有注射后 CMT 值均低于注射前值(均 p < 0.05)。DEX 组所有注射后 BCVA 均高于注射前值,PSTA 组注射后 1 个月 BCVA 高于注射前值(均 p < 0.05)。然而,PSTA 组注射后 3 个月和 6 个月的 BCVA 值差异无统计学意义(均 p > 0.05)。PSTA 组所有注射后 IOP 值差异无统计学意义(均 p > 0.05)。然而,DEX 组在注射后 1 个月和 3 个月时 IOP 显著升高(分别为 p < 0.05 和 p = 0.02)。首次注射后第 3 个月至第 6 个月,PSTA 组需要追加注射的患者比例显著高于 DEX 组(p = 0.006)。
玻璃体内 DEX 和 PSTA 注射治疗玻璃体切除术后 DME 均有效,但 DEX 治疗的患者视力改善持续时间更长,且需要追加注射的患者比例更少。