[1]丁浩轩,孙丽霞,吴沙仁高娃,等.Ozurdex治疗不同OCT分型的糖尿病性黄斑水肿患者的疗效和安全性[J].眼科新进展,2021,41(10):952-955.[doi:10.13389/j.cnki.rao.2021.0200]
　DING Haoxuan,SUN Lixia,WU Sharengaowa,et al.Efficacy and safety of Ozurdex in the treatment of patients with diabetic macular edema of different OCT types[J].Recent Advances in Ophthalmology,2021,41(10):952-955.[doi:10.13389/j.cnki.rao.2021.0200]
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Ozurdex治疗不同OCT分型的糖尿病性黄斑水肿患者的疗效和安全性/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
41卷
期数:
2021年10期
页码:
952-955
栏目:
应用研究
出版日期:
2021-10-05

文章信息/Info

Title:
Efficacy and safety of Ozurdex in the treatment of patients with diabetic macular edema of different OCT types
作者:
丁浩轩; 孙丽霞; 吴沙仁高娃; 于越瀛; 孙秋爽; 卢迪; 崔仁哲
133000　吉林省延吉市，延边大学附属医院眼科
Author(s):
DING Haoxuan; SUN Lixia; WU Sharengaowa; YU Yueying; SUN Qiushuang; LU Di; CUI Renzhe
Department of Ophthalmology,the Affiliated Hospital of Yanbian University,Yanji 133000,Jilin Province,China
关键词:
Ozurdex; 糖尿病性黄斑水肿; 光学相干断层扫描; 糖尿病
Keywords:
Ozurdex;  diabetic macular edema;  optical coherence tomography;  diabetes mellitus
分类号:
R774.5
DOI:
10.13389/j.cnki.rao.2021.0200
文献标志码:
A
摘要:
目的　探讨Ozurdex治疗不同OCT分型的糖尿病性黄斑水肿患者的疗效和安全性。方法　前瞻性研究。选取2019年10月至2020年11月就诊于我院眼科，经眼底检查、OCT、荧光素眼底血管造影确诊的糖尿病性黄斑水肿患者35例35眼。根据患者OCT采集图像，将存在黄斑区视网膜海绵样水肿且出现视网膜内弥漫性低反射的患者归入弥漫性黄斑水肿（DRT）组（12眼）；将黄斑区视网膜内存在高反射间隔和大小不一低反射囊腔的患者归入黄斑囊样水肿（CME）组（14眼），将黄斑中心凹厚度（CMT）增加、液体积聚并伴有浆液性视网膜脱离（SRD）的患者归入SRD组（9眼）。采用玻璃体内Ozurdex植入术治疗三组患者。对比观察三组患者术前及术后1个月、2个月、3个月、6个月的最佳矫正视力（BCVA）、CMT、眼压及术后不良反应事件发生情况。结果　三组患者随访期间BCVA差异均有统计学意义（F时间=108.047，P时间<0.001；F组间=3.840，P组间=0.032；F交互=2.797，P交互=0.011），表明在随访期内药物对患者视力有持续性改善作用。三组患者BCVA在治疗后2个月达到最佳水平，表明药物作用效果在2个月时达到最大。DRT组患者BCVA在随访的各个时间点均优于CME组和SRD组，差异均有统计学意义（均为P<0.05)；而CME组和SRD组患者BCVA在随访的各个时间点差异均不明显（均为P>0.05）。三组患者CMT在治疗后1个月均明显下降，并在治疗后2个月时达到随访最低，之后开始出现反弹，SRD组患者在随访期内CMT的变化幅度最大。三组患者在随访期间各时间点眼压差异有统计学意义（F时间=90.859，P时间＜0.001），说明药物具有明显的升眼压效应。三组患者从治疗后1个月开始眼压均有上升，并在治疗后3 个月开始下降。随访期内，所有患者均经过医学处理，未出现明显白内障加重、视网膜脱离或其他严重不良反应事件。结论　Ozurdex可有效改善不同OCT分型的糖尿病性黄斑水肿患者视功能和黄斑区视网膜形态。
Abstract:
Objective　To evaluate the efficacy and safety of Ozurdex in the treatment of diabetic macular edema with different OCT types. Methods　In the prospective study, 35 patients (35 eyes) with diabetic macular edema diagnosed by fundus examination, OCT and fundus fluorescein angiography in the Ophthalmology Department of our hospital from October 2019 to November 2020 were included. According to the OCT images of the patients, the patients with spongiform macular edema and diffuse low reflex in the retina were classified into diffuse macular edema (DRT) group (12 eyes), the patients with high reflex septum in macular retina and low reflection cysts of different sizes were classified into cystoid macular edema (CME) group (14 eyes), and the patients with thickened macular fovea, accumulated fluids and serous retinal detachment (SRD) were classified into SRD group (9 eyes). Intravitreal Ozurdex implantation was used to treat three groups of patients. The best corrected visual acuity (BCVA), central macular thickness (CMT), intraocular pressure (IOP) and postoperative adverse events were observed and compared among the three groups before operation and 1 month, 2 months, 3 months and 6 months after operation. Results　There were significant differences in BCVA among the three groups during the follow-up period (Ftime=108.047, Ptime<0.001, Finter-group=3.840, Pinter-group=0.032, Fcross=2.797, Pcross=0.011), indicating that the drug continuously improved patient’s visual acuity during the follow-up period. The BCVA of the three groups reached the best level at 2 months after treatment, indicating that the therapeutic effect of the drug reached the highest at 2 months. The BCVA of DRT group was better than that of CME group and SRD group at each time point, showing significant difference (P＜0.05), but there was no significant difference in BCVA between CME group and SRD group at each time point. The CMT of the three groups decreased significantly at 1 month after treatment, and reached the lowest at 2 months after treatment, and then began to rebound. The change of CMT was the largest in the SRD group during the follow-up period. There was a statistically significant difference in IOP among the three groups at each time point during the follow-up period (Ftime=90.859, Ptime<0.001), indicating a significant IOP boosting effect of Ozurdex. The IOP of the three groups increased from 1 month after treatment and began to decrease at 3 months. During the follow-up period, there was no significant aggravation of cataract, retinal detachment or other serious adverse events in any patients after medical treatment.Conclusion　Ozurdex can effectively improve the visual function and macular retinal morphology in patients with different types of DME.

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备注/Memo

备注/Memo:
国家自然科学基金项目（编号：81760171）；吉林省教育厅“十三五”科学技术项目（编号：JJKH20191117KJ）；吉林省科技发展计划项目（编号:20200201553JC）
更新日期/Last Update: 2021-10-05