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Widening use of dexamethasone implant for the treatment of macular edema

机译：地塞米松植入物在黄斑水肿治疗中的广泛应用

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Sustained-release intravitreal 0.7 mg dexamethasone (DEX) implant is approved in Europe for the treatment of macular edema related to diabetic retinopathy, branch retinal vein occlusion, central retinal vein occlusion, and non-infectious uveitis. The implant is formulated in a biodegradable copolymer to release the active ingredient within the vitreous chamber for up to 6 months after an intravitreal injection, allowing a prolonged interval of efficacy between injections with a good safety profile. Various other ocular pathologies with inflammatory etiopathogeneses associated with macular edema have been treated by DEX implant, including neovascular age-related macular degeneration, Irvine–Gass syndrome, vasoproliferative retinal tumors, retinal telangiectasia, Coats’ disease, radiation maculopathy, retinitis pigmentosa, and macular edema secondary to scleral buckling and pars plana vitrectomy. We undertook a review to provide a comprehensive collection of all of the diseases that benefit from the use of the sustained-release DEX implant, alone or in combination with concomitant therapies. A?MEDLINE search revealed lack of randomized controlled trials related to these indications. Therefore we included and analyzed all available studies (retrospective and prospective, comparative and non-comparative, randomized and nonrandomized, single center and multicenter, and case report). There are reports in the literature of the use of DEX implant across a range of macular edema-related pathologies, with their clinical experience supporting the use of DEX implant on a case-by-case basis with the aim of improving patient outcomes in many macular pathologies. As many of the reported macular pathologies are difficult to treat, a new treatment option that has a beneficial influence on the clinical course of the disease may be useful in clinical practice.
机译：欧洲已批准将缓释玻璃体内0.7 mg地塞米松（DEX）植入物用于治疗与糖尿病性视网膜病变，视网膜分支静脉阻塞，视网膜中央静脉阻塞和非感染性葡萄膜炎相关的黄斑水肿。在玻璃体内注射后，将植入物配制成可生物降解的共聚物，以在玻璃体内释放活性成分长达6个月，从而延长了两次注射之间的有效间隔，并具有良好的安全性。 DEX植入物已治疗了其他各种与黄斑水肿相关的炎性病因病的眼病理，包括新血管性年龄相关性黄斑变性，Irvine-Gass综合征，血管增生性视网膜肿瘤，视网膜毛细血管扩张，Coats病，放射性黄斑病，色素性视网膜炎和黄斑继发于巩膜扣和平面玻璃体切除术的水肿。我们进行了一项综述，以全面收集所有受益于单独使用缓释DEX植入物或与伴随疗法结合使用的疾病。 A？MEDLINE搜索显示缺乏与这些适应症相关的随机对照试验。因此，我们纳入并分析了所有可用的研究（回顾性和前瞻性研究，比较和非比较研究，随机和非随机研究，单中心和多中心研究以及病例报告）。有文献报道在各种与黄斑水肿相关的病变中使用DEX植入物，其临床经验支持逐案使用DEX植入物，目的是改善许多黄斑区的患者预后病理。由于许多报道的黄斑病变难以治疗，因此对疾病的临床病程具有有益影响的新治疗选择可能在临床实践中有用。

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