[1]冼志林,梁琦晨,袁洋行,等.地塞米松玻璃体内植入剂Ozurdex治疗视网膜静脉阻塞继发黄斑水肿的研究进展[J].眼科新进展,2020,40(3):296-300.[doi:10.13389/j.cnki.rao.2020.0069]
　XIAN Zhilin,LIANG Qichen,YUAN Yanghang,et al.Research advances on dexamethasone intravitreal implant Ozurdex for treatment of macular edema secondary to retinal vein occlusion[J].Recent Advances in Ophthalmology,2020,40(3):296-300.[doi:10.13389/j.cnki.rao.2020.0069]
点击复制

地塞米松玻璃体内植入剂Ozurdex治疗视网膜静脉阻塞继发黄斑水肿的研究进展/HTML
分享到：

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
40卷
期数:
2020年3期
页码:
296-300
栏目:
文献综述
出版日期:
2020-03-05

文章信息/Info

Title:
Research advances on dexamethasone intravitreal implant Ozurdex for treatment of macular edema secondary to retinal vein occlusion
作者:
冼志林; 梁琦晨; 袁洋行; 黄金飞; 王珂鳗; 翁宏武; 晏世刚
524023　广东省湛江市，广东医科大学研究生学院(冼志林，梁琦晨，袁洋行，晏世刚)； 529000　广东省江门市，江门市中心医院眼科（黄金飞）；528000　广东省佛山市，佛山市妇幼保健院眼科（王珂鳗）；516000　广东省惠州市，惠州市第一人民医院眼科（翁宏武）; 528000　广东省佛山市，佛山市第二人民医院眼科中心（晏世刚）
Author(s):
XIAN Zhilin1; LIANG Qichen1; YUAN Yanghang1; HUANG Jinfei2; WANG Keman3; WENG Hongwu4; YAN Shigang1; 5
1.Graduate School of Guangdong Medical University,Zhanjiang 524023,Guangdong Province,China2.Department of Ophthalmology，Jiangmen Central Hospital ,Jiangmen 529000,Guangdong Province,China3.Department of Ophthalmology，Foshan Women and Children Hospital,Foshan 528000,Guangdong Province,China4.Department of Ophthalmology，Huizhou First Hospital,Huizhou 516000,Guangdong Province,China5.Department of Ophthalmology，the Second People’s Hospital of Foshan,Foshan 528000,Guangdong Province,China
关键词:
地塞米松玻璃体内植入剂Ozurdex; 黄斑水肿; 视网膜静脉阻塞
Keywords:
dexamethasone intravitreal implant Ozurdex;  macular edema;  retinal vein occlusion
分类号:
R774
DOI:
10.13389/j.cnki.rao.2020.0069
文献标志码:
A
摘要:
视网膜静脉阻塞继发黄斑水肿（RVO-ME）为一种严重危害视功能的常见眼底表现，原因在于视网膜静脉血栓形成，造成视网膜毛细血管压力升高，导致血-视网膜内外屏障破坏，血管通透性增加，血管内血液成分渗透到血管外。到目前为止,抗血管内皮生长因子、玻璃体内注射曲安奈德及视网膜激光光凝等已经成为治疗RVO-ME的主要方法，但近年来地塞米松玻璃体内植入剂（Ozurdex）逐渐应用于RVO-ME的治疗，其生物可降解缓释特性、能有效提高最佳矫正视力、减少中央视网膜厚度、作用时间长、安全性较好及不良反应相对较少等优点越来越受到青睐。现就Ozurdex的作用机制和药理特性，以及其对RVO-ME的治疗进展进行综述。
Abstract:
Macular edema secondary to retinal vein occlusion (RVO-ME) is a common fundus disease that severely impairs visual function, and is caused by retinal vein thrombosis, which increases retinal capillary pressure and damages the internal and external blood-retinal barriers, leading to increase of vascular permeability and blood components penetrating blood vessels to outside. So far, anti-VEGF, intravitreal injection of triamcinolone and retinal laser photocoagulation, etc. have become the main treatment methods for RVO-ME. However, in recent years, dexamethasone intravitreal implants (Ozurdex) have gradually been applied to the treatment of RVO-ME. With the biodegradable sustained-release characteristics, Ozurdex can effectively improve the best corrected visual acuity, reduce the central retinal thickness, and has longer duration of action, more safety and fewer adverse reactions relatively. This article reviews the mechanism of action, pharmacological properties of Ozurdex and its progress in the treatment of RVO-ME.

参考文献/References:

［1］　SIVAPRASAD S,AMOAKU W M,HYKIN P,GUIDELINE G R.The Royal College of Ophthalmologists Guidelines on retinal vein occlusions: executive summary［J］.Eye (Lond),2016,30(4):642.
［2］　HEIER J S,CAMPOCHIARO P A,YAU L,LI Z,SAROJ N,RUBIO R G,et al.Ranibizumab for macular edema due to retinal vein occlusions: long-term follow-up in the HORIZON trial［J］.Ophthalmology,2012,119(4):802-809.
［3］　MISHRA S K,GUPTA A,PATYAL S,KUMAR S,RAJI K,SINGH A,et al.Intravitreal dexamethasone implant versus triamcinolone acetonide for macular oedema of central retinal vein occlusion: quantifying efficacy and safety［J］.Int J Ret Vit,2018,4:13.
［4］　PICHI F,SPECCHIA C,VITALE L,LEMBO A,MORARA M,VERONESE C,et al.Combination therapy with dexamethasone intravitreal implant and macular grid laser in patients with branch retinal vein occlusion［J］.Am J Ophthalmol,2014,157(3):607-615.
［5］　TERASHIMA H,HASEBE H,OKAMOTO F,MATSUOKA N,SATO Y,FUKUCHI T.Combination therapy of intravitreal ranibizumab and subthreshold micropulse photocoagulation for macular edema secondary to branch retinal vein occlusion: 6-month result［J］.Retina,2019,39(7):1377-1384.
［6］　TADAYONI R,WALDSTEIN S M,BOSCIA F,GERDING H,GEKKIEVA M,BARNES E,et al.Sustained benefits of ranibizumab with or without laser in branch retinal vein occlusion: 24-month results of the BRIGHTER study［J］.Ophthalmology,2017,124(12):1778-1787.
［7］　MATURI R K,BLEAU L,SAUNDERS J,MUBASHER M,STEWART M W.A 12-month,single-masked,randomized controlled study of eyes with persistent diabetic macular edema after multiple anti-vegf injections to assess the efficacy of the dexamethasone-delayed delivery system as an adjunct to bevacizumab compared with continued bevacizumab monotherapy［J］.Retina,2015,35(8):1604-1614.
［8］　HALLER J A,BANDELLO F,BELFORT R,BLUMENKRANZ M S,GILLIES M,HEIER J,et al.Dexamethasone intravitreal implant in patients with macular edema related to branch or central retinal vein occlusion［J］.Ophthalmology,2011,118(12):2453-2460.
［9］　SADDA S,DANIS R P,PAPPURU R R,KEANE P A,JIAO J,LI X Y,et al.Vascular changes in eyes treated with dexamethasone intravitreal implant for macular edema after retinal vein occlusion［J］.Ophthalmology,2013,120(7):1423-1431.
［10］　CHANG-LIN J E,BURKE J A,PENG Q,LIN T,ORILLA W C,GHOSN C R,et al.Pharmacokinetics of a sustained-release dexamethasone intravitreal implant in vitrectomized and nonvitrectomized eyes［J］.Invest Ophthalmol Vis Sci,2011,52(7):4605-4609.
［11］　ILHAN N,COSKUN M,ILHAN O,AYHAN TUZCU E,DAGLIOGLU M C,ELBEYLI A,et al.Effect of intravitreal injection of dexamethasone implant on corneal endothelium in macular edema due to retinal vein occlusion［J］.Cutan Ocul Toxicol,2014,34(4):294-297.
［12］　冯燕兵，朱洁云，翁文庆.生物可降解激素缓释剂Ozurdex治疗黄斑水肿的研究进展［J］.眼科新进展,2016,36(9):889-893.
FENG Y B,ZHU J Y,WENG W Q.Research progress on biodegradable hormone SUStained-release agent Ozurdex for macular edema［J］.Rec Adv Ophthalmol，2016,36(9):889-893.
［13］　SIMSEK M,CITIRIK M,OZATES S,OZKOYUNCU D.The efficacy of intravitreal dexamethasone implant as the first-line treatment for retinal vein occlusion-related macular edema in a real-life scenario［J］.Indian J Ophthalmol,2018,66(6):831-836.
［14］　谷潇雅，戴虹，喻晓兵.地塞米松玻璃体腔植入剂治疗视网膜静脉阻塞继发黄斑水肿一年临床观察［J］.中华眼底病杂志,2018,34(3):221-227.
GU X Y,DAI H,YU X B,One year clinical observation of dexamethasone intravitreal implant (Ozurdex) in the treatment of macular edema secondary to retinal vein occlusion［J］.Chin J Ocul Fundus Dis,2018,34(3):221-227.
［15］　SCOTT I U,IP M S,VANVELDHUISEN P C,ODEN N L,BLODI B A,FISHER M,et al.A randomized trial comparing the efficacy and safety of intravitreal triamcinolone with standard care to treat vision loss associated with macular edema secondary to branch retinal vein occlusion: the standard care vs corticosteroid for retinal vein occlusion (SCORE) study report 6［J］.Arch Ophthalmol,2009,127(9):1115-1128.
［16］　PARODI M B,IACONO P,PETRUZZI G,PARRAVANO M,VARANO M,BANDELLO F.Dexamethasone implant for macular edema secondary to ischemic retinal vein occlusions［J］.Retina,2015,35(7):1387-1392.
［17］　YEH W S,HALLER J A,LANZETTA P,KUPPERMANN B D,WONG T Y,MITCHELL P,et al.Effect of the duration of macular edema on clinical outcomes in retinal vein occlusion treated with dexamethasone intravitreal implant［J］.Ophthalmology,2012,119(6):1190-1198.
［18］　PULIDO J S,FLAXEL C J,ADELMAN R A,HYMAN L,FOLK J C,OLSEN T W.Retinal vein occlusions preferred practice pattern(R) guidelines［J］.Ophthalmology,2016,123(1):P182-P208.
［19］　COSCAS G,LOEWENSTEIN A,AUGUSTIN A,BANDELLO F,BATTAGLIA PARODI M,LANZETTA P,et al.Management of retinal vein occlusion-consensus document［J］.Ophthalmologica,2011,226(1):4-28.
［20］　KUPPERMANN B D,HALLER J A,BANDELLO F,LOEWENSTEIN A,JIAO J,LI X Y,et al.Onset and duration of visual acuity improvement after dexamethasone intravitreal implant in eyes with macular edema due to retinal vein occlusion［J］.Retina,2014,34(9):1743-1749.
［21］　GADO A S,MACKY T A.Dexamethasone intravitreous implantversus bevacizumab for central retinal vein occlusion-related macular oedema: a prospective randomized comparison［J］.Clin Exp Ophthalmol,2014,42(7):650-655.
［22］　CAPONE J A,SINGER M A,DODWELL D G,DREYER R F,OH K T,ROTH D B,et al.Efficacy and safety of two or more dexamethasone intravitreal implant injections for treatment of macular edema related to retinal vein occlusion (Shasta study)［J］.Retina,2014,34(2):342-351.
［23］　MATONTI F,HOFFART L,BAETEMAN C,DENIS D.Repeated treatment for macular edema in vein occlusion by intravitreal implant of Dexamethasone［J］.Case Reports Ophthalmol,2012,3(3):339-342.
［24］　SINGER M A,JANSEN M E,TYLER L,WOODS P,ANSARI F,JAIN U,et al.Long-term results of combination therapy using anti-VEGF agents and dexamethasone intravitreal implant for retinal vein occlusion: an investigational case series［J］.Clin Ophthalmol,2017,11:31-38.
［25］　IU L P,ZHAO P,YEUNG I Y,FUNG N S,LEE J W,WONG R L,et al.Sequential therapy with ranibizumab and dexamethasone intravitreal implant is better than dexamethasone monotherapy for macular oedema due to retinal vein occlusion［J］.Br J Ophthalmol,2015,99(2):210-214.
［26］　MAYER W J,REMY M,WOLF A,KOOK D,KAMPIK A,ULBIG M,et al.Comparison of intravitreal bevacizumab upload followed by a dexamethasone implant versus dexamethasone implant monotherapy for retinal vein occlusion with macular edema［J］.Ophthalmologica,2012,228(2):110-116.
［27］　FASSBENDER A J,JUSUFBEGOVIC D,SCHAAL S.Common and rare ocular side-effects of the Dexamethasone implant［J］.Ocul Immunol Inflamm,2017,25(6):834-840.
［28］　LI X,WANG N,LIANG X,XU G,LI X Y,JIAO J,et al.Safety and efficacy of dexamethasone intravitreal implant for treatment of macular edema secondary to retinal vein occlusion in Chinese patients: randomized,sham-controlled,multicenter study［J］.Graefes Arch Clin Exp Ophthalmol,2018,256(1):59-69.
［29］　MATURI R K,GLASSMAN A R,LIU D,BECK R W,BHAVSAR A R,BRESSLER N M,et al.Effect of adding dexamethasone to continued ranibizumab treatment in patients with persistent diabetic macular edema［J］.JAMA Ophthalmol,2018,136(1):29-38.
［30］　MATURI R K,POLLACK A,UY H S,VARANO M,GOMES A M,LI X Y,et al.Intraocular pressure in patients with diabetic macular edema treated with dexamethasone intravitreal implant in the 3-year mead study［J］.Retina,2016,36(6):1143-1152.
［31］　AFSHAR A R,LOH A R,PONGSACHAREONNONT P,SCHWARTZ D M,STEWART J M.Dexamethasone intravitreal implant trapped at the macula in a silicone oil-filled eye［J］.Ophthalmology,2013,120(12):2748-2749.
［32］　KIM J A,LEE E J,PARK K H,WOO S J.In vivo cross-sectional imaging of a degrading dexamethasone intravitreal implant that became attached to the macula［J］.JAMA Ophthalmol,2015,133(3):848-851.
［33］　GARAY-ARAMBURU G,GOMEZ-MORENO A.Choroidal detachment due to hypotony after intravitreal injection of dexamethasone implant［J］.JAMA Ophthalmol,2013,131(10):1.
［34］　CHRISTENSEN L,SANDERS R,OLSON J.“Magic Bullet”:Eccentric macular hole as a complication from dexamethasone implant insertion［J］.Case Rep Ophthalmol Med,2016,2016:1706234.
［35］　CASATI S,BRUNI E,MARCHINI G.Retinal and vitreous hemorrhage after traumatic impact of dexamethasone implant in a vitrectomized eye［J］.Eur J Ophthalmol,2016,26(3):e55-e57.
［36］　STEPANOV A,CODENOTTI M,RAMONI A,PRATI M,JIRASKOVA N,ROZSIVAL P,et al.Anterior chamber migration of dexamethasone intravitreal implant (Ozurdex(R)) through basal iridectomy (Ando) in a pseudophakic patient［J］.Eur J Ophthalmol,2016,26(3):e52-e54.
［37］　STELTON C R,TOWNSEND J,PETERSON L T,KHURANA R N,YEH S.Surgical management of anterior chamber migration of a dexamethasone intravitreal implant［J］.Ophthalmic Surg Lasers Imaging Retina,2015,46(7):756-759.
［38］　STEM M S,TODORICH B,YONEKAWA Y,CAPONE A,WILLIAMS G A,RUBY A J.Incidence and visual outcomes of culture-proven endophthalmitis following dexamethasone intravitreal implant［J］.JAMA Ophthalmol,2017,135(4):379-382.

相似文献/References:

[1]李国兴 韩丽英.曲安奈德玻璃体腔注射治疗黄斑水肿[J].眼科新进展,2008,28(9):000.
[2]周正申 孙静芬.白内障超声乳化术后黄斑区光学相干断层扫描观察[J].眼科新进展,2013,33(2):000.
[3]刘广峰 蔺洁 范颖 顾铮 高新晓 朱岩 孟忻 王华 贾宇颂 付秀稳 汪军.非增生型糖尿病视网膜病变黄斑水肿患者黄斑区谱域光学相干断层扫描中高反射信号的特征分析[J].眼科新进展,2013,33(4):000.
[4]鲁丹 王康 王艳玲 林鹏耀 李茜 李明铭.后Tenon囊下注射曲安奈德辅助全视网膜光凝治疗糖尿病视网膜病变[J].眼科新进展,2013,33(5):000.
[5]张祺 冯劼 李培凤 金翼.Lucentis联合氪黄激光治疗视网膜分支静脉阻塞黄斑水肿的疗效观察[J].眼科新进展,2013,33(12):000.
[6]陆秉文 吴星伟.视网膜静脉阻塞黄斑水肿患者玻璃体内注射ranibi-zumab后视野变化[J].眼科新进展,2013,33(12):000.
[7]徐斌 戴奕娟 梁丽 杨露. 传统格栅样激光与577nm黄色微脉冲激光光凝治疗黄斑水肿疗效对比[J].眼科新进展,2014,34(2):181.
[8]陈素芳 曾莉 邵毅. 非诺贝特在糖尿病视网膜病变中的应用进展[J].眼科新进展,2014,34(3):283.
[9]肖昂,周琼.Aflibercept治疗湿性AMD和黄斑水肿的相关研究现状[J].眼科新进展,2014,34(6):598.[doi:10.13389/j.cnki.rao.2014.0165]
[10]曹婷婷,陈桂芬,范玉香,等.视网膜分支静脉阻塞合并黄斑水肿不同治疗方法的疗效观察[J].眼科新进展,2014,34(8):772.[doi:10.13389/j.cnki.rao.2014.0213]
　CAO Ting-Ting,CHEN Gui-Fen,FAN Yu-Xiang,et al.Clinical observation in different treatment methods of branch retinal vein occlusion[J].Recent Advances in Ophthalmology,2014,34(3):772.[doi:10.13389/j.cnki.rao.2014.0213]

备注/Memo

备注/Memo:
广东省佛山市十三五医学重点专科和特色专科建设项目( 编号: FSGSPZD135020)
更新日期/Last Update: 2020-03-05