Abstract：
OBJECTIVE: To objectively assess the immediate response to intravitreal treatment for macular edema and compare it across different agents.
METHODS: This retrospective, comparative study included patients with macular edema due to diabetic retinopathy (DME) or vein occlusion who were treated with intravitreal injections of either steroids (triamcinolone acetonide or dexamethasone sustained release implant) or anti-vascular endothelial growth factor antibodies (VEGF). The central retinal thickness (CRT) and the best corrected visual acuity (BCVA) were measured 1 day after the injection and compared with immediate pre-injection values.
RESULTS: There were 79 eyes (57 patients) including 51 eyes with DME, 18 with branch retinal vein occlusion edema (BRVO-ME), and 10 eyes with central retinal vein occlusion edema (CRVO-ME). The intravitreal agents were triamcinolone acetonide (TA)(n = 15), dexamethasone sustained release implant (DEX)(n = 22), ranibizumab (n = 19), and bevacizumab (n = 23). Statistically significant improvement in CRT was seen in all injection groups (p < 0.05) while improvement in mean BCVA was significant only in the TA group (p = 0.009). The mean change in CRT was maximum with steroids than with anti-VEGFs; viz. 159.47 µ in TA, 115.45 µ in DEX, 86.10 µ in ranibizumab, and 78.78 µ in bevacizumab group. Least amount of change was noted in the spongy type of macular edema (18.73 µ) while improvement in mean BCVA was statistically significant only in the cystoid group (p = 0.01).
CONCLUSIONS: Comparatively, steroid agents showed better immediate response to therapy than anti-VEGFs. Maximum reduction in central retinal thickness was seen following triamcinolone acetonide injection. Cystoid edema showed better immediate response than spongy retinal thickening.
METHODS: This retrospective, comparative study included patients with macular edema due to diabetic retinopathy (DME) or vein occlusion who were treated with intravitreal injections of either steroids (triamcinolone acetonide or dexamethasone sustained release implant) or anti-vascular endothelial growth factor antibodies (VEGF). The central retinal thickness (CRT) and the best corrected visual acuity (BCVA) were measured 1 day after the injection and compared with immediate pre-injection values.
RESULTS: There were 79 eyes (57 patients) including 51 eyes with DME, 18 with branch retinal vein occlusion edema (BRVO-ME), and 10 eyes with central retinal vein occlusion edema (CRVO-ME). The intravitreal agents were triamcinolone acetonide (TA)(n = 15), dexamethasone sustained release implant (DEX)(n = 22), ranibizumab (n = 19), and bevacizumab (n = 23). Statistically significant improvement in CRT was seen in all injection groups (p < 0.05) while improvement in mean BCVA was significant only in the TA group (p = 0.009). The mean change in CRT was maximum with steroids than with anti-VEGFs; viz. 159.47 µ in TA, 115.45 µ in DEX, 86.10 µ in ranibizumab, and 78.78 µ in bevacizumab group. Least amount of change was noted in the spongy type of macular edema (18.73 µ) while improvement in mean BCVA was statistically significant only in the cystoid group (p = 0.01).
CONCLUSIONS: Comparatively, steroid agents showed better immediate response to therapy than anti-VEGFs. Maximum reduction in central retinal thickness was seen following triamcinolone acetonide injection. Cystoid edema showed better immediate response than spongy retinal thickening.
摘要：
目的：客观评估玻璃体内治疗黄斑水肿的即时反应，并比较不同药物之间的反应。
方法：本回顾性研究，对比研究纳入了糖尿病性视网膜病变(DME)或静脉阻塞引起的黄斑水肿患者,这些患者接受了玻璃体腔注射类固醇(曲安奈德或地塞米松缓释植入物)或抗血管内皮生长因子抗体(VEGF)治疗.注射后1天测量中央视网膜厚度（CRT）和最佳矫正视力（BCVA），并与立即注射前的值进行比较。
结果：79只眼（57例），其中51只眼患有DME，18伴有视网膜分支静脉阻塞水肿（BRVO-ME），10只眼视网膜中央静脉阻塞水肿(CRVO-ME)。玻璃体内药物是曲安奈德（TA）（n=15），地塞米松缓释植入物（DEX）（n=22），雷珠单抗（n=19），和贝伐单抗（n=23）。在所有注射组中观察到CRT的统计学显著改善(p<0.05),而平均BCVA的改善仅在TA组中显著(p=0.009)。与抗VEGF相比，类固醇的CRT平均变化最大；即。159.47µinTA,115.45µinDEX,雷珠单抗中的86.10µ，贝伐单抗组78.78µ。海绵状黄斑水肿的变化最小（18.73µ），而平均BCVA的改善仅在囊样组中具有统计学意义（p=0.01）。
结论：相比之下，类固醇药物对治疗的即时反应优于抗VEGF药物.注射曲安奈德后，中央视网膜厚度最大程度地减少。膀胱样水肿比海绵状视网膜增厚表现出更好的即时反应。
方法：本回顾性研究，对比研究纳入了糖尿病性视网膜病变(DME)或静脉阻塞引起的黄斑水肿患者,这些患者接受了玻璃体腔注射类固醇(曲安奈德或地塞米松缓释植入物)或抗血管内皮生长因子抗体(VEGF)治疗.注射后1天测量中央视网膜厚度（CRT）和最佳矫正视力（BCVA），并与立即注射前的值进行比较。
结果：79只眼（57例），其中51只眼患有DME，18伴有视网膜分支静脉阻塞水肿（BRVO-ME），10只眼视网膜中央静脉阻塞水肿(CRVO-ME)。玻璃体内药物是曲安奈德（TA）（n=15），地塞米松缓释植入物（DEX）（n=22），雷珠单抗（n=19），和贝伐单抗（n=23）。在所有注射组中观察到CRT的统计学显著改善(p<0.05),而平均BCVA的改善仅在TA组中显著(p=0.009)。与抗VEGF相比，类固醇的CRT平均变化最大；即。159.47µinTA,115.45µinDEX,雷珠单抗中的86.10µ，贝伐单抗组78.78µ。海绵状黄斑水肿的变化最小（18.73µ），而平均BCVA的改善仅在囊样组中具有统计学意义（p=0.01）。
结论：相比之下，类固醇药物对治疗的即时反应优于抗VEGF药物.注射曲安奈德后，中央视网膜厚度最大程度地减少。膀胱样水肿比海绵状视网膜增厚表现出更好的即时反应。
