地塞米松玻璃体内植入剂在非感染性葡萄膜炎的应用

Application of dexamethasone intravitreal implant in non-infectious uveitis

非感染性葡萄膜炎是严重危害视力的常见眼病,主要累及青壮年,病情反复,治疗棘手。局部及全身应用糖皮质激素是首选治疗方案。地塞米松玻璃体内植入剂是一种新型的生物可降解激素缓释剂,可在6个月内持续平稳释放不含防腐剂的地塞米松,最终完全降解为二氧化碳和水,2017年被国家食品药品监督管理总局批准用于非感染性葡萄膜炎的治疗。其可应用于儿童及成人非感染性葡萄膜炎,临床疗效好,在减轻玻璃体浑浊、降低黄斑水肿、提高视力方面的作用明显;同时,其可减少全身糖皮质激素使用剂量,降低发生全身不良反应的危险。如果病情反复发作,可以重复治疗。并发症方面,眼压升高和白内障是其主要并发症,但多数可以控制,手术干预率低。其长期安全性方面尚缺乏证据,有待进行进一步研究。

Non-infectious uveitis is a common eye disease that seriously jeopardizes vision.It mainly affects young and middle-aged people.The condition is repeated and the treatment is tricky.Local and systemic application of glucocorticoids is the primary choice of treatment.Dexamethasone intravitreal implant is a new biodegradable hormone sustained release agent,which can continuously releases dexamethasone without preservatives within 6 months in 2017.It can be completely degraded to carbon dioxide and water,and approved by China Food and Drug Administration for the treatment of non-infectious uveitis.It can be used in children and adults,and has good clinical curative effect.It has obvious effects in reducing vitreous opacity,reducing macular edema,and improving vision.In addition,it can reduce the dose of systemic glucocorticoids and reduce the risk of systemic adverse reactions.If the disease recurs,the treatment can be repeated.In terms of complications,elevated intraocular pressure and cataract are the major complications.But most of them can be controlled and the rate of surgical intervention is low.There is still no evidence for its long-term safety,and further research is needed.