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玻璃体内注射地塞米松植入物可用于治疗非感染性葡萄膜炎。

Intravitreal dexamethasone implant results in the treatment of non-infectious uveitis.

作者信息

Dikmen Nejla Tukenmez, Vural Ece Turan, Yenerel Nursal Melda, Dikkaya Funda, Elibol Emine Savran, Kockar Alev

机构信息

Department of Ophthalmology, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkiye.

Department of Ophthalmology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkiye.

出版信息

North Clin Istanb. 2022 Dec 21;9(6):638-645. doi: 10.14744/nci.2021.92342. eCollection 2022.

Abstract

OBJECTIVE

The objective of this study was to evaluate the efficacy of intravitreal dexamethasone implant in non-infectious uveitic macular edema.

METHODS

Between April 2013 and February 2017, 27 eyes of 21 patients were included in the study at Haydarpasa Numune Training and Research Hospital. The files of patients who underwent intravitreal dexamethasone implantation for non-infectious uveitic macular edema and followed up at least 6 months were retrospectively reviewed. The patients were evaluated in terms of best-corrected visual acuity (BCVA) and central macular thickness (CMT) before and at the 1, 3, and 6 months after injection and the need for re-injection.

RESULTS

Twenty-seven eyes of 21 patients were included in the study. The mean age of the patients was 39.2±11.7 years. The mean monitoring time was 24.15±10.08 months. In patients who received single-dose intravitreal dexamethasone implant, the decrease in CMT measurements and improvement in BCVA measurements at 1, 3, and 6 months after injection compared to baseline was found to be statistically significant (p=0.001 for each). Recurrence was detected in 33.3% (n=9) of the cases during follow-up; in cases with recurrence, second implants were repeated after an average of 9.67±3.12 months. The third dexamethasone implantation was applied due to the second relapse of four cases from nine relapsing cases. Third implants were performed at an average of 12.50±4.79 months. During the follow-up period, the most common complications in our patients were cataract (37%) and increased intraocular pressure (40.7%).

CONCLUSION

Intravitreal dexamethasone implantation is an effective and reliable treatment option in non-infectious uveitic macular edema. There was no difference between the first dose and re-implantations in terms of efficacy and safety.

摘要

目的

本研究的目的是评估玻璃体内注射地塞米松植入物治疗非感染性葡萄膜炎性黄斑水肿的疗效。

方法

2013年4月至2017年2月期间,海达尔帕萨努穆内培训与研究医院纳入了21例患者的27只眼。对因非感染性葡萄膜炎性黄斑水肿接受玻璃体内地塞米松植入并随访至少6个月的患者病历进行回顾性分析。在注射前、注射后1个月、3个月和6个月时,根据最佳矫正视力(BCVA)和中心黄斑厚度(CMT)对患者进行评估,并评估再次注射的必要性。

结果

本研究纳入了21例患者的27只眼。患者的平均年龄为39.2±11.7岁。平均监测时间为24.15±10.08个月。接受单剂量玻璃体内地塞米松植入物的患者,与基线相比,注射后1个月、3个月和6个月时CMT测量值的降低和BCVA测量值的改善具有统计学意义(每次p = 0.001)。随访期间33.3%(n = 9)的病例出现复发;复发病例中,平均9.67±3.12个月后重复进行第二次植入。9例复发病例中有4例因第二次复发接受了第三次地塞米松植入。第三次植入平均在12.50±4.79个月时进行。随访期间,患者最常见的并发症是白内障(37%)和眼压升高(40.7%)。

结论

玻璃体内注射地塞米松植入物是治疗非感染性葡萄膜炎性黄斑水肿的一种有效且可靠的治疗选择。首次注射与再次植入在疗效和安全性方面无差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/01a9/9833378/7938cd0f9359/NCI-9-638-g001.jpg

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