Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China,
Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Ophthalmic Res. 2023;66(1):247-258. doi: 10.1159/000527447. Epub 2022 Oct 10.
The purpose of the study was to investigate the long-term effect of intravitreal dexamethasone (DEX) implant and anti-vascular endothelial growth factor (VEGF) injection on macular edema (ME) secondary to retinal vein occlusion (RVO) in a real-world setting.
The medical records of RVO-ME cases, with intravitreal injections and followed up for at least 5 years, were retrospectively reviewed. Changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT) were primary outcomes. Images of fluorescence angiography and swept-source optical coherence tomography angiography were analyzed. Foveal avascular zone (FAZ) metrics and perfusion density at the last visit were also compared between the two treatments.
A total of 16 patients were recruited, 8 in the anti-VEGF group and 8 in the DEX group. At the 5th year, the BCVA and the CMT in the DEX group were not different from those in the anti-VEGF group (0.69 ± 0.36 LogMAR vs. 0.57 ± 0.30 LogMAR, p = 0.574; 183.25 ± 97.31 µm vs. 195.38 ± 40.92 µm, p = 0.442). Compared with the anti-VEGF group, the DEX group had higher FAZ circularity index (0.57 ± 0.14 vs. 0.68 ± 0.14, p = 0.130) and higher retinal perfusion density (0.45 ± 0.02 vs. 0.39 ± 0.03, p = 0.001), especially in the deep capillary plexus.
DEX implant and anti-VEGF injection had comparative long-term effects on RVO-ME. Compared with the anti-VEGF treatment, the DEX treatment had advantages in maintaining retinal perfusion in patients with RVO.
本研究旨在探讨玻璃体内注射地塞米松（DEX）植入物和抗血管内皮生长因子（VEGF）注射对视网膜静脉阻塞（RVO）继发的黄斑水肿（ME）的长期疗效。
回顾性分析接受玻璃体内注射并至少随访 5 年的 RVO-ME 患者的病历。最佳矫正视力（BCVA）和中央黄斑厚度（CMT）的变化为主要结局。分析荧光血管造影和扫频源光学相干断层扫描血管造影图像。还比较了两种治疗方法最后一次就诊时的中心凹无血管区（FAZ）指标和灌注密度。
共纳入 16 例患者，其中抗 VEGF 组 8 例，DEX 组 8 例。第 5 年时，DEX 组的 BCVA 和 CMT 与抗 VEGF 组无差异（0.69 ± 0.36 LogMAR 比 0.57 ± 0.30 LogMAR，p = 0.574；183.25 ± 97.31 µm 比 195.38 ± 40.92 µm，p = 0.442）。与抗 VEGF 组相比，DEX 组的 FAZ 圆形度指数更高（0.57 ± 0.14 比 0.68 ± 0.14，p = 0.130），视网膜灌注密度更高（0.45 ± 0.02 比 0.39 ± 0.03，p = 0.001），尤其是在深层毛细血管丛中。
DEX 植入物和抗 VEGF 注射对 RVO-ME 的长期疗效相当。与抗 VEGF 治疗相比，DEX 治疗在维持 RVO 患者的视网膜灌注方面具有优势。
