ИНТРАВИТРЕАЛЬНЫЙ ИМПЛАНТАТ ДЕКСАМЕТАЗОНА ПРИ ЛЕЧЕНИИ ОККЛЮЗИИ ВЕН СЕТЧАТКИ: ЭФФЕКТИВНОСТЬ И БЕЗОПАСНОСТЬ

Oftal mokhirurgiya

А. Е. Яворский¹  В. В. Бурий²  А. В. Кулагина³  О. Ю. Трунева⁴  Е. Г. Бадажков⁵ 

[1] БУЗ ОО «Клиническая офтальмологическая больница им. В.П. Выходцева», Омск;Иркутский филиал ФГБУ «МНТК «Микрохирургия глаза» им. акад. С.Н. Федорова» Минздрава России;НУЗ «Дорожная клиническая больница на станции Новосибирск-Главный ОАО «РЖД», Новосибирск;ООО «Клиника лазерной микрохирургии глаза», Красноярск;ООО «Центр микрохирургии глаза «Финист», Южно-Сахалинск

关键词: retinal vein occlusion;    macular edema;    intravitreal implant of dexamethasone;    окклюзия вен сетчатки;    макулярный отек;    интравитреальный имплантат дексаметазона;   

DOI  :  10.25276/0235-4160-2015-2-68-72

学科分类：眼科学

来源: M H T K Mikrokhirurgiya Glaza

【 摘 要 】

Purpose.To evaluate the efficacy and safety of dexamethasone intravitreal implant in the treatment of macular edema (ME) secondary to retinal vein occlusion. Material and methods.The results of dexamethasone intravitreal implant injections in 77 patients (77 eyes) with ME due to non-ischemic central or branch retinal vein occlusion (CRVO or BRVO) were retrospectively analyzed. The age of patients ranged from 32 to 84 years (mean age 59.8±11.5 years), 40 male, 37 female. Thirty nine patients had the CRVO, 38 – the BRVO. The duration of the disease at the moment of dexamethasone implant intravitreal injection (IVI) ranged from 2 days to 1.5 years. Results.We did not record intra- and post-operative complications. The IVI procedure and postoperative period were well tolerated for patients. The visual acuity did not show statistically significant changes 7-10 days after the IVI. The IOP ranged from 9.7 to 27.0mmHg. The elevated intraocular pressure (Po>21.0mmHg) was observed in 6 (7.7%) patients, however, the difference was not statistically significant. The central retinal thickness (CRT) decreased significantly (p=0.017) and ranged from 102 to 1196μm. One month after the IVI the visual acuity significantly improved (p<0.001), and ranged from 0.01 to 1.0. The IOP was within 10.5 to 30.0mmHg. The increased intraocular pressure (Po>21.0mmHg) was detected in 13 patients (16.9%), but it was statistically insignificant. The CRT decreased in comparison with the status 7-10 days later significantly (p=0.002) and ranged from 107 to 615μm. The visual acuity 3 months after the IVI was not significantly changed (with respect to the results after 1 month) and varied from 0.01 to 1.0. The IOP was within 10.0 to 32.0mmHg, the IOP increase (Po>21.0mmHg) was revealed in 11 (14.3%) patients, but it was statistically insignificant. The CRT was not changed significantly (with respect to the results after 1 month), and ranged from 107 to 771μm. Eight (10.4%) patients had a relapse (rising) of macular edema. The visual acuity 6 months after IVI was not significantly changed (with respect to the results after 3 months) and ranged from 0.02 to 1.0. The IOP was within 10.0 to 26.0mmHg, the IOP increase (Po>21.0mmHg) was detected in 5 (6.5%) patients, but it was statistically insignificant. In addition to those patients who showed the ME growth 3 months after the IVI, another 14 (18.2%) patients were diagnosed with relapse (rising) edema. Thus, 6 months later the ME relapse was diagnosed in 22 patients (28.6%). In 2 patients from this group the vitrectomy with membrane peeling (removal of internal limiting membrane) was performed, 6 patients underwent the repeated IVI. During the 6 month follow-up after a single IVI only one (1.3%) patient showed a progression of complicated cataract, due to this fact cataract phacoemulsification with intraocular lens implantation was carried out. Conclusion.Ozurdex medicine demonstrated an efficacy and a safety in the treatment of macular edema due to central or branch retinal vein occlusion.

【 授权许可】

CC BY