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Short-Term Results of Dexamethasone Intravitreal Implant in Patients with Refractory Diabetic Macular Edema
À̽ÂÈñ ( Lee Seung-Hee ) - ´©³×¾È°úº´¿ø
±è½Ã¿ ( Kim Si-Yeol ) - ´©³×¾È°úº´¿ø
¹ÚÇÑ»ó ( Park Han-Sang ) - ´©³×¾È°úº´¿ø
Abstract
¸ñÀû: º£¹Ù½ÃÁÖ¸¿°ú Æ®¸®¾Ï½Ã³î·Ð º´ÇÕ ¿ä¹ý¿¡ ¹ÝÀÀÇÏÁö ¾Ê´Â ³Ä¡¼º ´ç´¢È²¹ÝºÎÁ¾¿¡¼ À¯¸®Ã¼° ³» µ¦»ç¸ÞŸÁ¸ ÀÓÇöõÆ®(Ozurdex) ÁÖÀÔ ½Ã Ȳ¹ÝºÎÁ¾¿¡ ´ëÇÑ Ä¡·á È¿°ú¸¦ ¾Ë¾Æº¸°íÀÚ ÇÏ¿´´Ù.
´ë»ó°ú ¹æ¹ý: ³Ä¡¼º ´ç´¢È²¹ÝºÎÁ¾À¸·Î µ¦»ç¸ÞŸÁ¸ ÀÓÇöõÆ®¸¦ ÁÖÀÔÇÑ 9¸í 9¾ÈÀ» ´ë»óÀ¸·Î Àǹ«±â·ÏÀ» ÈÄÇâÀûÀ¸·Î ºÐ¼®ÇÏ¿´´Ù. À¯¸® ü° ³» º£¹Ù½ÃÁÖ¸¿ ÁÖÀÔ¼ú°ú ÈÄÅ×³í³¶ÇÏ È¤Àº À¯¸®Ã¼° ³» Æ®¸®¾Ï½Ã³î·Ð ÁÖÀÔ¼úÀÇ º´ÇÕ¿ä¹ý¿¡µµ ¹ÝÀÀÇÏÁö ¾Ê°í 3°³¿ù ÀÌ»ó Áö¼ÓµÇ ´Â ´ç´¢È²¹ÝºÎÁ¾ ȯÀÚµéÀ» ´ë»óÀ¸·Î, ½Ã¼ú Àü°ú 1, 3, 4°³¿ù°ÀÇ ÃÖ´ë ±³Á¤½Ã·Â, Áß½É È²¹Ý µÎ²²¸¦ Æò°¡ÇÏ¿´´Ù.
°á°ú: Æò±Õ °æ°ú°üÂû ±â°£Àº 6.7 ¡¾ 2.2°³¿ùÀ̾ú°í, ½Ã¼ú Àü ÃÖ´ë±³Á¤½Ã·ÂÀº 0.8 ¡¾ 0.48 logMAR¿¡¼ ½Ã¼ú ÈÄ 1, 3, 4°³¿ù° °¢°¢ 0.61 ¡¾ 0.37 logMAR (p=0.017), 0.57 ¡¾ 0.38 logMAR (p=0.011), 0.62 ¡¾ 0.36 logMAR (p=0.027)·Î È£ÀüµÇ¾ú´Ù. Áß½É È²¹Ý µÎ²²´Â ½Ã¼ú Àü 558.0 ¡¾ 110.32 ¥ìm¿¡¼ 1°³¿ù° 325 ¡¾ 64.21 ¥ìm (p=0.008), 3°³¿ù° 300.22 ¡¾ 59.46 ¥ìm (p=0.008)·Î È£ÀüµÇ¾ú´Ù°¡ 4°³¿ù° 468.44 ¡¾ 150.85 ¥ìm (p=0.058)·Î Áõ°¡µÇ¾ú´Ù.
°á·Ð: µ¦»ç¸ÞŸÁ¸ ÀÓÇöõÆ®´Â º£¹Ù½ÃÁÖ¸¿°ú Æ®¸®¾Ï½Ã³î·Ð º´ÇÕ ¿ä¹ý¿¡ ¹ÝÀÀÇÏÁö ¾Ê´Â ³Ä¡¼º ´ç´¢È²¹ÝºÎÁ¾ÀÇ ´Ü±â°£ Ä¡·á¿¡ È¿°úÀû À̾ú´Ù. ½Ã·Â È£Àü ¹× Áß½É È²¹Ý µÎ²²ÀÇ °¨¼Ò´Â 3°³¿ù°£ À¯ÁöµÇ¾úÀ¸¸ç 4°³¿ù° Á᫐ ¸Á¸· µÎ²²´Â ´Ù½Ã Áõ°¡ÇÏ¿´Áö¸¸ ½Ã·Â °³¼± È¿°ú´Â Á¶±Ý ´õ ¿À·¡ À¯ÁöµÇ¾ú´Ù.
Purpose: To evaluate the effectiveness of a dexamethasone intravitreal implant (Ozurdex) in the treatment of diabetic macular edema refractory to combined treatment of bevacizumab and triamcinolone.
Methods: We reviewed 9 eyes of 9 patients with diabetic macular edema treated with dexamethasone intravitreal implant. The patients were included in the study if presenting with refractory diabetic macular edema of more than 3 months despite combined treatment of intravitreal bevacizumab injection with posterior subtenon triamcinolone injection or intravitreal triamcinolone injection. We assessed the best-corrected visual acuity (BCVA) and central macular thickness (CMT) using optical coherence tomography at initial visit and 1, 3 and 4 months.
Results: The mean follow-up was 6.7 ¡¾ 2.2 months. The baseline mean BCVA was 0.81 ¡¾ 0.47 logarithm of the minimum angle of resolution (log MAR), which improved to 0.61 ¡¾ 0.37 log MAR (p = 0.017), 0.57 ¡¾ 0.38 log MAR (p = 0.011) and 0.62 ¡¾ 0.36 log MAR (p = 0.027) at 1 month, 3 months and 4 months, respectively. The baseline mean CMT was 558.0 ¡¾ 110.32 ¥ìm and decreased to 325 ¡¾ 64.21 ¥ìm (p = 0.008) and 300.22 ¡¾ 59.46 ¥ìm (p = 0.008) at 1 month and 3 months, respectively, then increased to 468.44 ¡¾ 150.85 ¥ìm (p = 0.058) at 4 months after injection.
Conclusions: Dexamethasone intravitreal implant showed short-term efficacy in the treatment of diabetic macular edema refractory to combined treatment of bevacizumab and triamcinolone and produced significant improvements in BCVA and CMT until 3 months after injection. The CMT then increased, but BCVA was sustained until the fourth month.
Ű¿öµå
Dexamethasone implant; Diabetic macular edema; Intravitreal injection
KMID :
0360220150560081201
DOI :
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