Abu Arif Jasmin, Knecht Vitus André, Rübsam Anne, Lussac Vanessa, Jami Zohreh, Pohlmann Dominika, Müller Bert, Pleyer Uwe
Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, 10117 Berlin, Germany.
Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Charité Platz 1, 10117 Berlin, Germany.
Biomedicines. 2024 May 16;12(5):1106. doi: 10.3390/biomedicines12051106.
Macular edema (ME) remains a primary cause of visual deterioration in uveitis. Visual acuity (VA) can often be maintained using corticosteroid depot systems. This study evaluated the efficacy of a fluocinolone acetonide (FAc) intravitreal implant (ILUVIEN) in treating non-infectious uveitis using real-world data. This retrospective analysis included 135 eyes subdivided into responders and non-responders. Central retinal thickness (CRT), VA, and intraocular pressure (IOP) were followed over time. A significant decrease in CRT and an increase in VA were observed in all eyes throughout the follow-up period ( < 0.01). An IOP increase ( = 0.028) necessitated treatment in 43% of eyes by Month 6. Non-responders were older ( = 0.004) and had been treated with more dexamethasone (DEX) implants ( = 0.04); 89.3% had a defect in the external limiting membrane (ELM) and inner/outer segment (IS/OS) zone ( < 0.001). Immunomodulatory therapy had no impact on treatment response. Pars plana vitrectomy (PPV) patients had a mean CRT reduction of 47.55 µm and a reduced effect by Month 24 ( = 0.046) versus non-PPV patients. We conclude that the FAc implant achieves long-term control of CRT and improves VA. Increases in IOP were manageable. Eyes with a previous PPV showed milder results. Data showed a correlation between older age, a damaged ELM and IS/OS zone, frequent DEX inserts, and poorer outcome measures.
黄斑水肿（ME）仍然是葡萄膜炎导致视力下降的主要原因。使用皮质类固醇长效制剂通常可以维持视力。本研究利用真实世界数据评估了醋酸氟轻松（FAc）玻璃体内植入物（ILUVIEN）治疗非感染性葡萄膜炎的疗效。这项回顾性分析纳入了135只眼睛，分为反应者和无反应者。随时间跟踪中心视网膜厚度（CRT）、视力（VA）和眼压（IOP）。在整个随访期间，所有眼睛的CRT均显著降低，VA升高（<0.01）。到第6个月时，43%的眼睛因眼压升高（=0.028）需要进行治疗。无反应者年龄较大（=0.004），接受过更多地塞米松（DEX）植入物治疗（=0.04）；89.3%的患者存在外限制膜（ELM）和内/外节（IS/OS）区域缺陷（<0.001）。免疫调节治疗对治疗反应没有影响。与未进行玻璃体切割术（PPV）的患者相比，PPV患者的平均CRT降低了47.55 µm，到第24个月时效果减弱（=0.046）。我们得出结论，FAc植入物可实现对CRT的长期控制并改善VA。眼压升高是可控的。既往接受过PPV的眼睛结果较轻微。数据显示年龄较大、ELM和IS/OS区域受损、频繁插入DEX与较差的结果指标之间存在相关性。
