Dexamethasone Intravitreal Implant: An Effective Adjunctive Treatment for Recalcitrant Noninfectious Uveitis
Dexamethasone Intravitreal Implant: An Effective Adjunctive Treatment for Recalcitrant Noninfectious Uveitis
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DOI：
10.1159/000343060
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发表时间：
2012-01-01
期刊：
影响因子：
2.6
通讯作者：
Bandello, F.
中科院分区：
文献类型：
--
作者：
Miserocchi, E.;Modorati, G.;Bandello, F.
目的：介绍应用0.7 mg地塞米松玻璃体内辅助抗炎治疗顽固性重症非感染性后葡萄膜炎的经验。方法：回顾性研究。对12例重度顽固性葡萄膜炎患者（女8例，男4例，患眼14眼，植体15眼）进行治疗。尽管使用了不同的免疫抑制剂和眼周皮质类固醇治疗，患者对葡萄膜炎的控制仍然不足。评估的主要结局指标为：葡萄膜炎活动性降低、视力改善、黄斑厚度减少和不良事件的发生。结果：所有患者种植后葡萄膜炎活动度均下降。注射后平均随访9个月。随访结束时，最佳矫正视力由20/80提高至20/40。视网膜平均厚度由496 μ m提高到226 μ m。不良事件发生：眼压升高3眼，玻璃体出血1眼，结膜下出血1眼。3例患者在治疗后减少了每日全身皮质类固醇剂量。结论：0.7 mg地塞米松玻璃体内植入似乎是一种新的、有希望的辅助治疗方法，用于对不同免疫抑制剂难以抵抗的严重后壁非感染性葡萄膜炎患者。巴塞尔S. Karger股份有限公司版权所有
Purpose: To describe our experience in treating recalcitrant and severe cases of noninfectious posterior uveitis with the 0.7-mg dexamethasone intravitreal implant as adjunctive anti-inflammatory treatment. Procedures: Retrospective study. Twelve patients (8 females; 4 males; 14 affected eyes, 15 implants) with severe recalcitrant uveitis were treated. Patients had an inadequate control of uveitis despite different immunosuppressants and periocular corticosteroid therapy. Primary outcome measures evaluated were: decrease in uveitis activity, improvement in visual acuity, reduction of macular thickness, and occurrence of adverse events. Results: Uveitis activity decreased in all patients after the implant. The mean follow-up time from injection was 9 months. Best-corrected visual acuity improved from 20/80 to 20/40 at the end of follow-up. The mean retinal thickness improved from 496 to 226 mu m. Adverse events encountered were: 3 eyes with intraocular pressure elevation, 1 vitreous hemorrhage and 1 subconjunctival hemorrhage. Three patients reduced the daily systemic corticosteroid dosage after treatment. Conclusions: The 0.7-mg dexamethasone intravitreal implant appears to be a novel and promising adjunctive treatment for patients with severe posterior noninfectious uveitis recalcitrant to different immunosuppressive agents. Copyright (C) 2012 S. Karger AG, Basel