EFFECT OF INTRAVITREAL TRIAMCINOLONE IN DIABETIC MACULAR EDEMA UNRESPONSIVE TO INTRAVITREAL BEVACIZUMAB
EFFECT OF INTRAVITREAL TRIAMCINOLONE IN DIABETIC MACULAR EDEMA UNRESPONSIVE TO INTRAVITREAL BEVACIZUMAB
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DOI：
10.1097/iae.0000000000000109
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发表时间：
2014-08-01
影响因子：
3.3
通讯作者：
Lee, Won Ki
中科院分区：
文献类型：
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作者：
Jeon, Sohee;Lee, Won Ki
目的：评价玻璃体内注射曲安奈德治疗对玻璃体内注射贝伐珠单抗无反应的糖尿病黄斑水肿的疗效。方法：纳入至少3个月玻璃体内注射贝伐珠单抗无反应的糖尿病黄斑水肿患者。在最后一次玻璃体内贝伐珠单抗治疗后至少2个月，在获得房水样本后进行玻璃体内曲安奈德治疗。采用多重细胞因子芯片检测血管内皮生长因子、白细胞介素（IL）-2、IL-6、IL-8、肿瘤坏死因子-α和转化生长因子-β（2）。术后0 ~ 3个月评价最佳矫正视力和中央视野厚度。基线时平均最佳矫正视力为47.1 +/- 18.9个字母，1个月时显著增加至53.3 +/- 19.7个字母（P = 0.002），2个月时显著增加至52.4 +/- 19.1个字母（P = 0.041）。3个月时，这些视力改善并未持续（50.9 +/- 18.6; P = 0.204）。在1个月时，12只眼睛的中央子场厚度下降超过基线的11%。多变量分析表明，IL-8（β = 0.538 P = 0.006）的眼内水平是一个独立的因素解剖responsibility.Conclusion：玻璃体内曲安奈德有一个作用，在短期内玻璃体内贝伐单抗反应不佳的患者。眼内IL-8水平升高与疗效相关。
Purpose: To evaluate the efficacy of intravitreal triamcinolone injection in diabetic macular edema unresponsive to intravitreal bevacizumab.Methods: Patients with diabetic macular edema unresponsive to at least three monthly intravitreal bevacizumabs were included. At least 2 months after the last intravitreal bevacizumab, intravitreal triamcinolone was performed after obtaining an aqueous humor sample. Multiplex cytokine array was used to assay vascular endothelial growth factor, interleukin (IL)-2, IL-6, IL-8, tumor necrosis factor-alpha, and transforming growth factor-beta(2). Best-corrected visual acuity and central subfield thickness were evaluated from Month 0 to 3.Results: Twenty eyes were enrolled. The mean best-corrected visual acuity was 47.1 +/- 18.9 letters at baseline, and significantly increased to 53.3 +/- 19.7 letters at 1 month (P = 0.002) and 52.4 +/- 19.1 letters at 2 months (P = 0.041). These visual gains were not sustained at 3 months (50.9 +/- 18.6; P = 0.204). A decrease in central subfield thickness more than 11% of baseline occurred in 12 eyes at 1 month. Multivariate analysis showed that intraocular levels of IL-8 (beta = 0.538 P = 0.006) was an independent factor for anatomic response at 1 month.Conclusion: Intravitreal triamcinolone has a role in patients who are unresponsive to intravitreal bevacizumab over the short-term. Elevated intraocular IL-8 levels were related to the efficacy.