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首页> 外文期刊>Ophthalmic Research: Journal for Research in Experimental and Clinical Ophthalmology >The Outcomes of Switching from Short- to Long-Term Intravitreal Corticosteroid Implant Therapy in Patients with Diabetic Macular Edema
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The Outcomes of Switching from Short- to Long-Term Intravitreal Corticosteroid Implant Therapy in Patients with Diabetic Macular Edema

机译：从短期到长期玻璃体内皮质类固醇植入治疗患者切换患者患糖尿病黄斑水肿

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Background: First-line treatment for diabetic macular edema (DME) is usually with antivascular endothelial growth factor agents, followed by intravitreal corticosteroids as a second-line treatment option. Long-term corticosteroids may offer quality of life and effectiveness benefits over short-term implants. Objectives: To evaluate outcomes of patients with persistent or recurrent DME who switched from a short-term (dexamethasone) to a long-term (fluocinolone acetonide, FAc) corticosteroid intravitreal implant in a real-world setting. Methods: This is a retrospective study in 9 Portuguese centers. An FAc intravitreal implant was administered according to product labeling. Effectiveness outcomes were mean change in visual acuity (VA; ETDRS letters), central retinal thickness (CRT; μm), and macular volume (MV; mm~(3)). The safety outcome was mean change in intraocular pressure (IOP; mm Hg). All were analyzed at months 1 and 3, and then quarterly until month 24 after implantation. Results: Forty-four eyes from 36 patients were analyzed. Mean duration of DME was 3.3 ± 1.9 years, and mean follow-up was 8 months. From baseline following FAc implantation, VA increased significantly at months 1 and 6 (mean +6.82 and +13.02 letters, respectively; p = 0.005), and last observation carried forward (LOCF; mean +8.3 letters; p = 0.002). CRT improved significantly at months 1 and 6 (mean –71.81 and –170.77 μm, respectively; p = 0.001), and LOCF (mean –121.46 μm; p = 0.001). MV was consistently, but not significantly, decreased from baseline to LOCF (mean –0.69 mm~(3); p = 0.062). The mean change in IOP was –0.25 and +0.88 mm Hg at months 1 and 6, respectively ( p = 0.268), and +1.86 mm Hg at LOCF ( p = 0.036). Increases were controlled with topical medication in most cases. Conclusions: The FAc intravitreal implant is effective in patients previously treated with short-term corticosteroid implants. Thus, after a suboptimal response to antiangiogenics or a short-term corticosteroid, a single FAc implant may be considered an effective and tolerable treatment that can improve long-term outcomes for patients with sight-threatening DME.
机译：背景技术：糖尿病黄斑水肿（DME）的一线治疗通常是用抗血管内皮生长因子剂，其次是玻璃体皮质类固醇作为第二线治疗方案。长期皮质类固醇可以提供短期植入物的生活质量和有效性。目的：评估从短期（地塞米松）转换为长期（氟氨酰醋酸盐，FAC）皮质类固醇玻璃体植入物的持续或经常性DME的患者的结果。方法：这是9葡萄牙中心的回顾性研究。根据产物标记施用FAC玻璃体植入物。有效结果是视力（VA; ETDRS字母），中央视网膜厚度（CRT;μm）和黄斑体积（MV; mm〜（3））中的平均变化。安全结果是眼内压（IOP; mm Hg）的平均变化。所有人都在几个月和3个，然后在植入后24个月分析。结果：分析了36例患者的四十四只四次眼睛。 DME的平均持续时间为3.3±1.9岁，平均随访时间为8个月。从BAS植入后的基线，VA分别在数月1和6（平均值+6.82和+13.02个字母）下显着增加; P = 0.005），并向前进的观察结果（LOCF;平均值+8.3字母; P = 0.002）。 CRT分别在数月1和6（平均值-71.81和-170.77μm）显着改善（平均值; P = 0.001），以及LOCF（平均-121.46μm; p = 0.001）。 MV始终如一，但没有显着，从基线降低到LOCF（平均值-0.69mm〜（3）; p = 0.062）。 IOP的平均变化分别为-0.25和+ 0.88mm Hg，分别（P = 0.268），+ 1.86mm Hg（p = 0.036）。在大多数情况下，通过局部药物增加增加。结论：FAC玻璃体内植入物在先前用短期皮质类固醇植入物治疗的患者有效。因此，在对抗血管生物学或短期皮质类固醇的次优响应之后，单个FAC植入物可以被认为是有效且可耐受的治疗方法，可以改善威胁视力DME患者的长期结果。

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