Gkiala Anastasia, Agapitou Chrysa, Dimitriou Eleni, Haidich Anna-Bettina, Tziola Tatiana, Theodossiadis Panagiotis, Mataftsi Asimina, Chatziralli Irini
Department of Ophthalmology, Birmingham Midland Eye Center, Birmingham, GBR.
2nd Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, GRC.
Cureus. 2025 Mar 11;17(3):e80391. doi: 10.7759/cureus.80391. eCollection 2025 Mar.
This study aims to present the long-term functional and anatomical outcomes of intravitreal dexamethasone (DEX) implant in patients with central retinal vein occlusion (CRVO) in real-world daily practice.
Retrospective study of consecutive patients with macular edema due to CRVO, treated with 0.7 mg DEX implant and had 48-month follow-up. Data on best-corrected visual acuity (BCVA) and central subfield thickness (CST) at months 12, 24, 36, and 48 after initiation of DEX implant treatment were collected from patients' charts. Patient demographics and co-morbidities were also recorded, while potential factors affecting the final anatomical and functional outcomes were assessed.
Thirty-one patients (31 eyes) received a mean number of 4.1±1.1 DEX implants and demonstrated significantly improved BCVA at all time-points of follow-up (p<0.001 for all comparisons). Accordingly, CST decreased significantly at all time-points of follow-up (p<0.001 for all comparisons). Treatment naïve patients were found to have lower BCVA at month 48 compared to those who had previously received intravitreal aflibercept, although there was no difference regarding CST between the two groups at month 48. When assessing factors that may predict the outcome, only naïve administration of treatment was found to have a negative correlation with BCVA at 48 months.
In this series of patients with macular edema secondary to CRVO, a demonstrable improvement in BCVA was recorded along with CST decrease at a long-term follow-up of four years. Only naïve treatment with DEX implant negatively correlated with visual acuity outcomes, but it was not confirmed at the multivariate analysis. Therefore, there was no evidence to support a predictive relationship between demographic and baseline anatomical factors and final BCVA and CST.
本研究旨在呈现玻璃体内注射地塞米松（DEX）植入物在现实日常临床实践中对视网膜中央静脉阻塞（CRVO）患者的长期功能和解剖学结局。
对因CRVO导致黄斑水肿且接受0.7 mg DEX植入物治疗并进行了48个月随访的连续患者进行回顾性研究。从患者病历中收集DEX植入物治疗开始后第12、24、36和48个月时的最佳矫正视力（BCVA）和中心子野厚度（CST）数据。记录患者的人口统计学和合并症情况，同时评估影响最终解剖学和功能结局的潜在因素。
31例患者（31只眼）平均接受了4.1±1.1次DEX植入物注射，在所有随访时间点BCVA均有显著改善（所有比较p<0.001）。相应地，在所有随访时间点CST均显著降低（所有比较p<0.001）。与之前接受过玻璃体内注射阿柏西普的患者相比，初治患者在第48个月时的BCVA较低，尽管两组在第48个月时的CST没有差异。在评估可能预测结局的因素时，仅发现初治与48个月时的BCVA呈负相关。
在这组继发于CRVO的黄斑水肿患者中，经过四年的长期随访，记录到BCVA有明显改善，同时CST降低。仅DEX植入物初治与视力结局呈负相关，但在多变量分析中未得到证实。因此，没有证据支持人口统计学和基线解剖学因素与最终BCVA和CST之间存在预测关系。
