地塞米松玻璃体内植入剂治疗顽固性糖尿病性黄斑水肿  

Efficacy of Dexamethasone implant injection in the treatment of persistent diabetic macular edema

作　　者：蔡萌[1] 丁相奇[1] Meng Cai;Xiang-Qi Ding(Cataract Ward Three,the Second People s Hospital of Zhengzhou,Zhengzhou 450006,Henan Province,China)

机构地区：[1]中国河南省郑州市第二人民医院白内障三病区,450006

出　　处：《国际眼科杂志》2021年第11期1984-1986,共3页International Eye Science

摘　　要：目的:观察地塞米松玻璃体内植入剂(DEX)治疗顽固性糖尿病性黄斑水肿(DME)的疗效。方法:回顾性研究。收集2019-06/2020-01于郑州市第二人民医院确诊为顽固性DME并行玻璃体腔内注射DEX患者30例30眼的临床资料。观察治疗前后最佳矫正视力(BCVA)、眼压、黄斑中心凹厚度(CMT)变化及并发症。结果:治疗后1、2、3、4、6mo BCVA(LogMAR)(0.57±0.53、0.42±0.48、0.43±0.26、0.45±0.66、0.51±0.37)较治疗前(0.86±0.47)显著提高(均P<0.05);治疗后1、2、3、4、6mo CMT(412.57±74.55、370.21±23.83、371.53±52.66、373.28±68.49、389.35±95.61μm)较治疗前(495.64±107.23μm)有差异(均P<0.05)。用药后2mo BCVA和CMT临床效果达到最佳,部分患者病情反复,再次出现视力下降及黄斑水肿加重,4眼于术后3mo、5眼于术后4mo及2眼于术后6mo,再次注射DEX。所有患者中4眼出现高眼压(≥22mmHg),应用降眼压药物后,眼压均控制在正常范围内。1眼出现白内障加重。随访6mo中未发生眼内炎、视网膜脱离等并发症。结论:玻璃体腔注射DEX可以有效提高顽固性DME患者BCVA,减轻黄斑水肿。AIM:To investigate the efficacy of dexamethasone implant injection in the treatment of persistent diabetic macular edema(DME).METHODS:The clinical data of 30 DME patients(30 eyes)after anti-vascular endothelial growth factor(anti-VEGF)agents from June 2019 to January 2020 were retrospectively analyzed.All patients had underwent intravitreal injection of DEX.Best corrected visual acuity(BCVA),intraocular pressure(IOP),central macular thickness(CMT)and adverse events were recorded.RESULTS:BCVA(LogMAR)was significantly improved from(0.86±0.47)to(0.57±0.53,0.42±0.48,0.43±0.26,0.45±0.66 and 0.51±0.37)at 1,2,3,4 and 6mo after treatment.CMT improved significantly from baseline(495.64±107.23)μm to(412.57±74.55,370.21±23.83,371.53±52.66,373.28±68.49,389.35±95.61)μm 1,2,3,4 and 6mo post-injection.The drug reached its peak efficacy 2mo after administration.4 eyes were given repeated injection at 3mo,5 eyes were given at 5mo and 2 eyes were given at 6mo following the primary injection.Cataract progression was showed in 1 case.4 patients demonstrated IOP levels above 22mmHg and were mostly controllable by IOP-lowering medications.None of patients showed any adverse events at 6mo of follow-up.CONCLUSION:Dexamethasone implant injection showed significant BCVA and CMT improvement.DEX injection may be utilized as an effective DME therapy for patients who are persistent after anti-VEGF treatment.

关 键 词：地塞米松玻璃体内植入剂 顽固性糖尿病性黄斑水肿 玻璃体腔注射 

分 类 号：R587.2[医药卫生—内分泌] R779.6[医药卫生—内科学]