摘要
目的评估地塞米松玻璃体内植入剂(Ozurdex)联合口服糖皮质激素治疗难治性非感染性葡萄膜炎的效果。方法前瞻性随机对照研究。纳入齐齐哈尔市第一医院2020年1至12月治疗的难治性非感染性葡萄膜炎55例(64只眼),采用随机数字表法分为两组,A组29例(32只眼)应用Ozurdex玻璃体内植入联合口服糖皮质激素;B组26例(32只眼)单纯口服糖皮质激素。治疗后随访24个月,比较两组治疗后最佳矫正视力(BCVA,logMAR)、黄斑中心区厚度(CMT)、荧光素视网膜血管渗漏发生率、玻璃体浑浊度、糖皮质激素用药时长、复发率及并发症情况。结果64例患者病程(7.89±1.14)个月。随访末期:A组BCVA为0.23±0.17,CMT为(201.70±6.75)μm,玻璃体浑浊度评分为0.69±0.42,均优于B组的BCVA(0.32±0.19)及CMT[(275.34±3.64)μm],玻璃体浑浊度评分1.52±0.27(均P<0.05)。荧光素视网膜血管渗漏发生率分别于治疗后6个月和12个月与B组相比差异有统计学意义(χ^(2)=4.43,4.73;P=0.035,0.029)。结论Ozurdex玻璃体植入联合糖皮质激素口服可有效稳定难治性非感染性葡萄膜炎,显著改善视力、副作用小、复发率低。
Objective To evaluate the efficacy of dexamethasone intravitreal implant(Ozurdex)combined with oral corticosteroids in the treatment of refractory non-infectious uveitis.Methods This was a prospective randomized controlled study.A total of 64 eyes of 55 cases with refractory non-infectious in the First Hospital of Qiqihar from Jan.to Dec.2020 were collected,and all cases were divided randomly into two groups based on random number table method.in the group A,(32 eyes)29 cases of treated with intravitreal ozurdex injections and oral corticosteroids.In the group B,(32 eyes)26 cases of treated with oral glucocorticoids alone.They were followed up for 24 months after treatment.Best corrected visual acuity(BCVA,logMAR),central macular thickness(CMT),incidence of vascular leakage of fluorescein,vitreous turbidity,duration of glucocorticoid administration,recurrence rate and complications were compared between the two groups at 3,6,12 and 24 months after treatment.Results Sixty-four patients had a mean age of(34.52±2.17)years and a mean disease duration for(7.89±1.14)months.At the end of the follow-up time,BCVA of group A was 0.23±0.17,CMT was(201.70±6.75)μm,and vitreous turbidity score was 0.69±0.42,all of which were better than those of group B[0.32±0.17,(275.34±3.64)μm,1.52±0.27](all P<0.05).Incidence of retinal vascular leakage of group A varied significantly at 6 and 12 months after treatment compared to group B,respectively(χ^(2)=4.43,4.73;P=0.035,0.029).Conclusion Ozurdex implantation and oral corticosteroids for the treatment of refractory non-infectious uveitis can effectively improve vision,and with fewer side-effects,low recurrence rate.
作者
路航
王索曦
李卓
崔璟琳
修巍威
宋先德
刘博洋
李佳瑶
金超明
赵安琪
丁虹阳
Lu Hang;Wang Suoxi;Li Zhuo;Cui Jinglin;Xiu Weiwei;Song Xiande;Liu Boyang;Li Jiayao;Jin Chaoming;Zhao Anqi;Ding Hongyang(Department of Ophthalmology,the First Hospital of Qiqihar,Qiqihar 161000,China;Mudanjiang Medical University,Mudanjiang 157000,China)
出处
《中华眼外伤职业眼病杂志》
2023年第8期572-579,共8页
Chinese Journal of Ocular Trauma and Occupational Eye Disease
