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0.19毫克曲安奈德玻璃体内植入治疗糖尿病性黄斑水肿的真实世界研究结果

Real-World Outcomes of the 0.19 mg Fluocinolone Acetonide Intravitreal Implant for Diabetic Macular Edema.

作者信息

Morozova Christine, Humayun Lucas L, Kasper Jonathan, Morozov Andy, Tabandeh Homayoun, Boyer David S, Dayani Pouya N, Rahhal Firas M

机构信息

Retina Vitreous Associates Medical Group, Los Angeles, CA, USA.

Keck School of Medicine at the University of Southern California, Los Angeles, CA, USA.

出版信息

J Vitreoretin Dis. 2024 May 16;8(4):394-400. doi: 10.1177/24741264241247624. eCollection 2024 Jul-Aug.

Abstract

To evaluate the real-world clinical and safety outcomes of a 0.19 mg fluocinolone acetonide intravitreal implant to treat diabetic macular edema (DME). This retrospective analysis comprised patients treated with a single fluocinolone acetonide intravitreal implant for the clinical indication of ME secondary to diabetic retinopathy. Primary outcomes included changes in best-corrected visual acuity (BCVA), central subfield thickness (CST), and the frequency of DME-related treatments 12 months before and up to 36 months after fluocinolone acetonide administration. Safety outcomes were also assessed. One hundred forty-eight eyes (115 patients) were followed for a mean (±SD) of 12.3 ± 4.2 months before and 29.4 ± 14.5 months after fluocinolone acetonide administration. A 0.8-letter decrease (Early Treatment Diabetic Retinopathy Study) in the mean BCVA was observed at month 24. The BCVA was 70 letters (20/40 Snellen equivalent) or more in 20.6% of eyes at baseline and in 23.7% of eyes 24 months after implant administration. The mean CST was 379.9 μm and 323.7 μm, respectively. The CST was 300 μm or less in 58.7% of eyes at month 24 ( < .001). The mean frequency of intravitreal antivascular endothelial growth factor injections or laser photocoagulation decreased from 4.9 to 1.5 per year after fluocinolone acetonide administration ( < .001). Implant migration to the anterior chamber occurred in 3 eyes, 2 of which were vitrectomized and later required removal. The 0.19 mg fluocinolone acetonide intravitreal implant provided long-term stabilization of VA and macular anatomy in patients with DME, despite a significant reduction in treatment frequency.

摘要

评估0.19毫克醋酸氟轻松玻璃体内植入物治疗糖尿病性黄斑水肿(DME)的真实世界临床和安全性结果。这项回顾性分析纳入了因糖尿病性视网膜病变继发黄斑水肿这一临床指征而接受单次醋酸氟轻松玻璃体内植入物治疗的患者。主要结局包括给药前12个月直至醋酸氟轻松给药后36个月最佳矫正视力(BCVA)、中心子野厚度(CST)的变化以及DME相关治疗的频率。还评估了安全性结果。148只眼(115例患者)在醋酸氟轻松给药前平均(±标准差)随访12.3±4.2个月,给药后随访29.4±14.5个月。在第24个月时观察到平均BCVA下降了0.8个字母(早期治疗糖尿病性视网膜病变研究标准)。基线时20.6%的眼BCVA为70个字母(相当于Snellen视力表20/40)或更高,植入物给药24个月后这一比例为23.7%。平均CST分别为379.9微米和323.7微米。在第24个月时,58.7%的眼CST为300微米或更低(P<0.001)。醋酸氟轻松给药后,玻璃体内抗血管内皮生长因子注射或激光光凝的平均频率从每年4.9次降至1.5次(P<0.001)。3只眼发生植入物向前房移位,其中2只眼接受了玻璃体切除术,随后需要取出植入物。尽管治疗频率显著降低,但0.19毫克醋酸氟轻松玻璃体内植入物为DME患者提供了视力和黄斑解剖结构的长期稳定。

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