Begiker-Ophthalmology Research Group, Department of Ophthalmology, Biocruces Bizkaia Health Research Institute, OSI Bilbao Basurto, Facultad de Medicina, Campus de Basurto, University of the Basque Country, UPV/EHU, Avenida Montevideo 18, 48013, Bilbao, Spain.
The Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
Sci Rep. 2024 Mar 13;14(1):6122. doi: 10.1038/s41598-024-56581-6.
To compare baseline characteristics, initial response and 12-month efficacy and safety outcomes in eyes with branch and central retinal vein occlusion (BRVO and CRVO) treated with dexamethasone implants (DEX) or anti-vascular endothelial growth factor (anti-VEGF) we performed a multi-centre, retrospective and observational study using Fight Retinal Blindness! Registry. Of 725 eligible eyes, 10% received DEX initially with very frequent adjunctive anti-VEGF (BRVO-DEX 49%, CRVO-DEX 60%). The primary outcome of mean adjusted change in VA at 12 months with DEX and anti-VEGF initiated groups were not statistically significantly different (BRVO: DEX + 6.7, anti-VEGF + 10.6 letters; CRVO: DEX + 2.8, anti-VEGF + 6.8 letters). DEX initiated eyes had fewer injections and visits than anti-VEGF initiated eyes. The BRVO-DEX eyes had greater initial mean changes in VA and central subfield thickness (CST) and achieved inactivity sooner than BRVO-anti-VEGF eyes. The mean CST after the first three months was above 350 μm in all but the BRVO-anti-VEGF group, suggesting undertreatment. In routine care DEX is uncommonly used when available as initial treatment of BRVO and CRVO requiring supplemental anti-VEGF within the first year. The 12-month outcomes were similar, but DEX initiated eyes had fewer injections and visits but more episodes of raised IOP Vs those starting anti-VEGF.
为了比较接受地塞米松植入物（DEX）或抗血管内皮生长因子（anti-VEGF）治疗的分支和中央视网膜静脉阻塞（BRVO 和 CRVO）患者的基线特征、初始反应和 12 个月的疗效和安全性结局，我们使用 Fight Retinal Blindness! 登记处进行了一项多中心、回顾性和观察性研究。在 725 例符合条件的眼中，10%的患者最初接受 DEX 治疗，且非常频繁地辅助使用抗 VEGF（BRVO-DEX 为 49%，CRVO-DEX 为 60%）。用 DEX 和抗 VEGF 启动组的平均调整视力变化作为主要结局，在 12 个月时没有统计学显著差异（BRVO：DEX+6.7，抗 VEGF+10.6 个字母；CRVO：DEX+2.8，抗 VEGF+6.8 个字母）。与抗 VEGF 启动组相比，启动 DEX 治疗的眼的注射次数和就诊次数更少。BRVO-DEX 眼的初始 VA 和中央视网膜神经纤维层厚度（CST）变化更大，且更早达到无活动状态，而 BRVO-anti-VEGF 眼则更慢。除 BRVO-anti-VEGF 组外，所有组在首次三个月后的平均 CST 均高于 350μm，表明治疗不足。在常规护理中，DEX 很少被用作 BRVO 和 CRVO 的初始治疗，如果在第一年需要补充抗 VEGF，则选用 DEX。12 个月的结果相似，但与抗 VEGF 治疗组相比，启动 DEX 治疗的眼的注射次数和就诊次数更少，但眼压升高的次数更多。
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