MACULAR EDEMA TREATMENT TRIALS ASSOCIATED WITH MUST (META-MUST)

项目总结 黄斑水肿是葡萄膜炎患者视力丧失的最常见原因。 虽然治疗葡萄膜炎黄斑水肿的方法有多种，但没有 对这些治疗方法进行了对比试验。这项提案的目标是 是解决葡萄膜炎黄斑水肿治疗中的两个关键问题1)最佳 葡萄膜黄斑水肿的初始治疗；以及2)持续性黄斑水肿的最佳治疗 黄斑水肿(即最初治疗后仍未消退的黄斑水肿)。 局部皮质类固醇注射是治疗葡萄膜炎黄斑的主要方法 浮肿。然而，有不同的路线和配方，从来没有 在试验中进行比较，而缺乏最终试验导致了相当大的变异性 临床实践。对于持续性黄斑水肿，重复注射皮质类固醇 通常都是用药的。然而，玻璃体内注射甲氨蝶呤和玻璃体内注射甲氨蝶呤的试点研究 玻璃体内注射雷尼比珠单抗(Lucentis)提示有效，可能只需较少的眼球 副作用然后对这些方法进行了对比试验。这个 研究组存在葡萄膜黄斑水肿。试验的具体目的 1)比较曲安奈德眼周的相对疗效， 曲安奈德玻璃体腔内注射和地塞米松玻璃体内注射 植入物(Ozurdex)治疗葡萄膜炎黄斑水肿；2)比较 玻璃体内注射雷尼珠单抗(Lucentis)、玻璃体内注射甲氨蝶呤、 地塞米松玻璃体内植入治疗葡萄膜炎 玻璃体内注射曲安奈德后仍持续的黄斑水肿。结果是 这些试验将指导临床医生关于基于以下问题的最佳方法 其广泛的专业知识和经过验证的记录，从成功的 完成必须试验，并对参与者进行持续的必须跟踪研究 在必须的审判中。

PROJECT SUMMARY Macular edema is the most common cause of visual loss among patients with uveitis. Although there are multiple approaches to the treatment of uveitic macular edema, no comparative trials of these treatments have been performed. The goal of this proposal is to address two critical issues in the treatment of uveitic macular edema 1) the optimal initial treatment for uveitic macular edema; and 2) the optimal treatment of persistent macular edema (i.e. macular edema that has not resolved after initial treatment). Regional corticosteroid injections are the mainstay of treatment for uveitic macular edema. However, there are different routes and formulations, which never have been compared in a trial, and the lack of definitive trials has led to considerable variability in clinical practice. For persistent macular edema, repeat injections of corticosteroids typically are administered. However, pilot studies of intravitreal methotrexate and of intravitreal ranibizumab (Lucentis) have suggested efficacy, possibly with fewer ocular side effects then comparative trials have been performed of these approaches. The existing MUST Research Group uveitic macular edema. The specific aims of the trials are: 1) to compare the relative effectiveness of periocular traimcinolone acetonide, intravitreal triamoinoione acetonide (Triescence), and the intravitreal dexamethasone implant (Ozurdex) for the treatment of uveitic macular edema; and 2) to compare the relative effectiveness of intravitreal ranizizumab (Lucentis), intravitreal methotrexate, and theintravitreal dexamethasone implant (Ozuradex) for the treatment of uveitic macular edema that persists after intravitreal triamoinolone injections. The results of these trials will guide clinicians regarding the best approaches for issues based upon both its breadth of expertise and proven track record, demonstrated by the successful completion of the MUST trial and by the ongoing MUST Follow-up Study of participants in the MUST Trial.