Dexamethasone Intravitreal Implant for Noninfectious Intermediate or Posterior Uveitis
Dexamethasone Intravitreal Implant for Noninfectious Intermediate or Posterior Uveitis
复制标题
DOI：
10.1001/archophthalmol.2010.339
复制
发表时间：
2011-05-01
影响因子：
--
通讯作者：
Whitcup, Scott M.
中科院分区：
文献类型：
--
作者：
Lowder, Careen;Belfort, Rubens, Jr.;Whitcup, Scott M.
目的：评价两种剂量地塞米松玻璃体内植入(DEX植入物)治疗非感染性中间或后葡萄膜炎的安全性和有效性。方法：在这项为期26周的试验中，非感染性中间或后葡萄膜炎患者随机分为两组：地塞米松玻璃体内植入0.70 mg(n=77)、地塞米松0.35 mg(n=76)。结果：植入0.7 mg地塞米松组、0.35 mg地塞米松植入组和假手术组8周玻璃体混浊评分为0的比例分别为47%、36%和12%(P<；.001)；这种益处持续到第26周。在所有研究访问中，DEX植入物组的最佳矫正视力较基线最佳矫正视力增加15个字母或更多的眼明显多于假植入组。植入0.7毫克地塞米松植入物的眼压达到或超过25毫米汞柱的比例最高，为7.1%，0.35毫克地塞米松植入物的为8.7%，而假植入眼压为4.2%(P>；0.05)。有晶状体眼植入0.7 mg地塞米松植入物后白内障发生率为15%(9/62)，0.35 mg地塞米松植入物植入后白内障发生率为12%(6/51)，非晶状体眼植入0.35 mg地塞米松植入物后6个月后白内障发生率为7%(4/55)。结论：在非感染性中间或后葡萄膜炎患者中，单次植入地塞米松可显著改善眼内炎症和视力持续6个月。
Objective: To evaluate the safety and efficacy of 2 doses of dexamethasone intravitreal implant (DEX implant) for treatment of noninfectious intermediate or posterior uveitis.Methods: In this 26-week trial, eyes with noninfectious intermediate or posterior uveitis were randomized to a single treatment with a 0.7-mg DEX implant (n = 77), 0.35-mg DEX implant (n = 76), or sham procedure (n = 76).Main Outcome Measure The main outcome measure was the proportion of eyes with a vitreous haze score of 0 at week 8.Results: The proportion of eyes with a vitreous haze score of 0 at week 8 was 47% with the 0.7-mg DEX implant, 36% with the 0.35-mg DEX implant, and 12% with the sham (P < .001); this benefit persisted through week 26. A gain of 15 or more letters from baseline best-corrected visual acuity was seen in significantly more eyes in the DEX implant groups than the sham group at all study visits. The percentage of eyes with intraocular pressure of 25 mm Hg or more peaked at 7.1% for the 0.7-mg DEX implant, 8.7% for the 0.35-mg DEX implant, and 4.2% for the sham (P > .05 at any visit). The incidence of cataract reported in the phakic eyes was 9 of 62 (15%) with the 0.7-mg DEX implant, 6 of 51 (12%) with the 0.35-mg DEX implant, and 4 of 55 (7%) with the sham (P > .05).Conclusions: In patients with noninfectious intermediate or posterior uveitis, a single DEX implant significantly improved intraocular inflammation and visual acuity persisting for 6 months.Application to Clinical Practice: Dexamethasone intravitreal implant may be used safely and effectively for treatment of intermediate and posterior uveitis.