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在真实世界中使用地塞米松玻璃体内植入物治疗非感染性后葡萄膜炎

Treatment of Non-Infectious Posterior Uveitis with Dexamethasone Intravitreal Implants in a Real-World Setting.

作者信息

Butt Farhat, Devonport Helen

机构信息

Opthalmology Department, Bradford Royal Infirmary, Duckworth Lane, BD9 6RJ, UK.

出版信息

Clin Ophthalmol. 2023 Feb 16;17:601-611. doi: 10.2147/OPTH.S393662. eCollection 2023.

Abstract

PURPOSE

The present study aimed to assess the efficacy and safety associated to the treatment of patients with non-infectious posterior uveitis with intravitreal dexamethasone (DEX) implants in a real-world clinical setting.

PATIENTS AND METHODS

This is a retrospective, single center analysis of the data from 29 patients with non-infectious posterior uveitis in whom 38 eyes were treated with dexamethasone intravitreal implants in routine clinical practice between January 2012 and October 2017. The parameters of visual acuity (VA), intraocular pressure (IOP) and central retinal thickness (CRT) were recorded 6 weeks after the first implant was administered, in accordance with the clinical guidelines for the use of these implants, and after a 6-month follow-up period. In addition, the formation of cataracts was evaluated at 12 months.

RESULTS

Treatment with the DEX implant caused a significant improvement in the VA from baseline at 6 weeks in eyes treated with 2-6 implants and for eyes without cataracts. A significant decrease in CRT was observed relative to the baseline at 6 weeks for eyes treated with 1 and 2-6 implants, which was maintained at 6 months for those eyes treated with 2-6 implants. This significant improvement in CRT at 6 weeks and 6 months was evident in eyes with and without cataracts. During the study period, the IOP was found to increase significantly from baseline at 6 weeks in some eyes but this was managed topically, and no surgical intervention was necessary.

CONCLUSION

Intravitreal DEX implants represent an effective and safe therapy for the treatment of non-infectious uveitis in routine clinical practice, producing favorable visual and anatomical outcomes after the administration of just 2-6 DEX implants.

摘要

目的

本研究旨在评估在真实临床环境中,玻璃体内注射地塞米松(DEX)植入物治疗非感染性后葡萄膜炎患者的疗效和安全性。

患者与方法

这是一项回顾性单中心分析,纳入了2012年1月至2017年10月期间在常规临床实践中接受玻璃体内地塞米松植入物治疗的29例非感染性后葡萄膜炎患者的38只眼睛的数据。根据这些植入物的临床使用指南,在首次植入后6周以及6个月随访期后,记录视力(VA)、眼压(IOP)和中心视网膜厚度(CRT)参数。此外,在12个月时评估白内障的形成情况。

结果

对于接受2 - 6次植入的眼睛以及无白内障的眼睛,DEX植入物治疗在6周时使VA相对于基线有显著改善。接受1次以及2 - 6次植入的眼睛在6周时CRT相对于基线显著降低,接受2 - 6次植入的眼睛在6个月时仍保持这一降低水平。无论有无白内障,在6周和6个月时CRT的这种显著改善均很明显。在研究期间,发现一些眼睛的IOP在6周时相对于基线显著升高,但通过局部治疗得以控制,无需手术干预。

结论

在常规临床实践中,玻璃体内DEX植入物是治疗非感染性葡萄膜炎的一种有效且安全的疗法,仅给予2 - 6次DEX植入物后即可产生良好的视觉和解剖学效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b128/9940496/8b6725d674cd/OPTH-17-601-g0001.jpg

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