PDF(Pubmed)
Abstract：
Macular edema (ME) remains a primary cause of visual deterioration in uveitis. Visual acuity (VA) can often be maintained using corticosteroid depot systems. This study evaluated the efficacy of a fluocinolone acetonide (FAc) intravitreal implant (ILUVIEN®) in treating non-infectious uveitis using real-world data. This retrospective analysis included 135 eyes subdivided into responders and non-responders. Central retinal thickness (CRT), VA, and intraocular pressure (IOP) were followed over time. A significant decrease in CRT and an increase in VA were observed in all eyes throughout the follow-up period (p < 0.01). An IOP increase (p = 0.028) necessitated treatment in 43% of eyes by Month 6. Non-responders were older (p = 0.004) and had been treated with more dexamethasone (DEX) implants (p = 0.04); 89.3% had a defect in the external limiting membrane (ELM) and inner/outer segment (IS/OS) zone (p < 0.001). Immunomodulatory therapy had no impact on treatment response. Pars plana vitrectomy (PPV) patients had a mean CRT reduction of 47.55 µm and a reduced effect by Month 24 (p = 0.046) versus non-PPV patients. We conclude that the FAc implant achieves long-term control of CRT and improves VA. Increases in IOP were manageable. Eyes with a previous PPV showed milder results. Data showed a correlation between older age, a damaged ELM and IS/OS zone, frequent DEX inserts, and poorer outcome measures.
摘要：
黄斑水肿（ME）仍然是葡萄膜炎视力恶化的主要原因。视力（VA）通常可以使用皮质类固醇储库系统来维持。这项研究使用真实世界数据评估了氟轻松（FAc）玻璃体内植入物（ILUNEN®）治疗非感染性葡萄膜炎的疗效。这项回顾性分析包括135只眼睛，细分为响应者和非响应者。中央视网膜厚度(CRT),VA,和眼压（IOP）随时间的推移进行随访。在整个随访期间，观察到所有眼睛的CRT显着降低和VA增加（p<0.01）。IOP增加(p=0.028)需要到第6个月治疗43%的眼睛。无反应者年龄较大（p=0.004），并接受了更多的地塞米松（DEX）植入物治疗（p=0.04）；89.3％的外界膜（ELM）和内/外节（IS/OS）区存在缺陷（p<0.001）。免疫调节治疗对治疗反应无影响。与非PPV患者相比，平坦部玻璃体切除术（PPV）患者的平均CRT降低为47.55µm，并且到第24个月时效果降低（p=0.046）。我们得出的结论是，FAc植入物可实现对CRT的长期控制并改善VA。IOP的增加是可控的。具有先前PPV的眼睛显示较温和的结果。数据显示老年人之间存在相关性，损坏的ELM和IS/OS区域，频繁的DEX插入，和较差的结果衡量标准。
