Bilici Serdar, Serbest Enes, Ugurbas Suat Hayri
Department of Ophthalmology, Zonguldak Bulent Ecevit University Faculty of Medicine, Zonguldak, Türkiye.
Beyoglu Eye J. 2023 Sep 13;8(3):193-197. doi: 10.14744/bej.2023.73644. eCollection 2023.
The objective of the study was to evaluate choroidal structural changes after intravitreal dexamethasone implant (IDI) in eyes with diabetic macular edema (DME) refractory to antivascular endothelial growth factor (VEGF) therapy.
Twenty-three eyes of 14 patients with DME refractory to anti-VEGF therapy were included in this retrospective study. Detailed ophthalmological examinations were recorded, and optical coherence tomography images were obtained before and 3 months after IDI. Choroidal images were binarized into the luminal area and total choroidal area. Subfoveal choroidal thickness and choroidal vascularity index (CVI) were calculated.
The mean best-corrected visual acuity (BCVA) and central macular thickness (CMT) were improved significantly (from 0.94 to 0.81 LogMAR, p=0.02, and from 464 to 371 μ, p=0.01, respectively) after IDI. There were no significant changes in both SCFT and CVI at the end of the follow-up period (from 446.3 to 428.8 μ, p=0.51 and from 63.1 to 63.7 p=0.35, respectively).
IDI in eyes with DME refractory to anti-VEGF therapy improves BCVA and CMT but has no significant effect on SCFT and CVI in the short term.
本研究的目的是评估玻璃体内注射地塞米松植入物（IDI）对糖尿病性黄斑水肿（DME）患者抗血管内皮生长因子（VEGF）治疗无效后的脉络膜结构变化。
本回顾性研究纳入了14例抗VEGF治疗无效的DME患者的23只眼。记录详细的眼科检查结果，并在IDI术前和术后3个月获取光学相干断层扫描图像。脉络膜图像被二值化为管腔面积和脉络膜总面积。计算黄斑中心凹下脉络膜厚度和脉络膜血管指数（CVI）。
IDI术后平均最佳矫正视力（BCVA）和中心黄斑厚度（CMT）显著改善（分别从0.94降至0.81 LogMAR，p = 0.02；从464μm降至371μm，p = 0.01）。随访期末，脉络膜中心凹下厚度（SCFT）和CVI均无显著变化（分别从446.3μm降至428.8μm，p = 0.51；从63.1降至63.7，p = 0.35）。
抗VEGF治疗无效的DME患者接受IDI治疗可改善BCVA和CMT，但短期内对SCFT和CVI无显著影响。
