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地塞米松玻璃体内植入剂治疗糖尿病性黄斑水肿的临床观察OA

Observation on the efficacy of dexamethasone intravitreal implant for the treatment of diabetic macular edema

中文摘要英文摘要

目的 观察地塞米松玻璃体内植入剂(傲迪适)对糖尿病性黄斑水肿(diabetic macular edema,DME)的治疗效果及安全性.方法 采用回顾性系列病例研究.选取 2022 年 1 月至 2023 年 1 月于天津河西普瑞眼科医院因DME接受傲迪适植入手术的患者 14 例(15 只眼),分别于治疗后 1 周、1 个月、2 个月、3 个月、4 个月、5 个月、6 个月复查,观察对比治疗前后最佳矫正视力(best corrected visual acuity,BCVA)、黄斑中心凹厚度(central retinal thickness,CMT)、眼压(intraocular pressure,IOP)及药物状态等.结果 治疗后各时间点BCVA与术前相比均有所提高,差异有统计学意义(F=6.93,P<0.05),治疗后 1 周、1 个月、2 个月、3 个月、4 个月、5 个月、6 个月CMT分别为(425.80±96.86)μm、(313.33±76.88)μm、(266.07±75.27)μm、(279.93±55.68)μm、(327.13±105.67)μm、(298.73±61.89)μm、(321.00±98.41)μm,与治疗前(575.00±136.82)μm 相比均显著下降,差异有统计学意义(F=18.91,P<0.05).治疗后伴随CMT 下降,黄斑部视网膜内囊肿、层间高反射点及视网膜下积液也逐步吸收,外界膜和椭圆体带也部分恢复.眼压在治疗后 5 个月内有轻度上升,与治疗前相比,差异有统计学意义(P<0.05),在治疗后 6 个月回归至治疗前水平,差异无统计学意义(P>0.05).结论 傲迪适治疗 DME 能够减轻黄斑水肿程度、恢复黄斑区视网膜形态及层间结构、提高视力.

Objective To observe the clinical efficacy of dexamethasone intravitreal implant(Ozurdex)in the treatment of diabetic macular edema(DME).Methods This was a retrospective clinical study,we selected 14 cases(15 eyes)with Ozurdex because of DME in Tianjin bright eye hospital from January 2022 to January 2023.The patients were followed up at 1 week,1 month,2 months,3 months,4 months,5 months and 6 months after operation to observe the best corrected visual acuity(BCVA),central retinal thickness(CMT),intraocular pressure(IOP)and the state of Ozurdex.Results The BCVA at each time point after treatment was higher than that before treatment(F=6.93,P<0.05),the CMT at 1 week[(425.80±96.86)μm],1 month[(313.33±76.88)μm],2 months[(266.07±75.27)μm],3 months[(279.93±55.68)μm],4 months[(327.13±105.67)μm],5 months[(298.73±61.89)μm]and 6 months[(321.00±98.41)μm]after operation were significantly lower than that before treatment[(575.00±136.82)μm](F=18.91,P<0.05).With the decrease of CMT after treatment,the intraretinal cysts,hyperreflective dots and subretinal fluid were gradually absorbed,the external limiting membrane and ellipsoid zone were also partially recovered.The intraocular pressure was significantly higher within 5 months after treatment than that before treatment(P<0.05),but did not change significantly at 6 months compared with before treatment(P>0.05).Conclusion Ozurdex can effectively reduce macular edema,restore retinal morphology and interlaminar structure,improve BCVA in the treatment of DME.

李刚;李岩

天津河西普瑞眼科医院眼底病科,天津 300200

临床医学

地塞米松;黄斑水肿;糖尿病视网膜病变

Dexamethasone;Macular edema;Diabetic retinopathy

《中国现代医生》 2024 (002)

67-71 / 5

10.3969/j.issn.1673-9701.2024.02.016

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