本研究旨在探討同步注射類固醇眼內釋放裝置(dexamethasone intravitreal implant ; DEX) 及抗血管新生藥物於黃斑部水腫病人之療效。病人接受同步注射類固醇眼內釋放裝置及抗血管新生藥物注射者為研究組，單純接受抗血管新生藥物注射者為對照組。病人的最佳矯正視力，黃斑部厚度，眼內壓數值皆從病歷中尋找並記錄。注射類固醇的常見副作用類固醇眼高壓症。本實驗總共收集了26位病人，各有13位病人在研究組以及對照組。經過三個月追蹤之後，接受合併治療的研究組病人之視力及黃斑部厚度皆相較於對照組或研究組注射前狀態有所改善。對照組則相較於術前無任何顯著變化。至於眼內壓，研究組及對照組相較於術前皆無明顯上升。至於類固醇眼高壓症僅有一位病人發生，且沒有單一次量測大於三十毫米汞柱者或需要手術治療者。不過有五位研究組的病人其眼壓上升需要藥物治療。同步注射類固醇眼內釋放裝置及抗血管新生藥物於黃斑部水腫病人是具有顯著療效的新式療法。另外，僅有中等程度的眼內壓上升代表合併治療之安全性在可接受範圍內。未來應該可進行更大規模的研究來調查此種合併治療的長期療效及安全性。 To evaluate the safety and efficiency in macular edema patients who concurrently received a single injection of a dexamethasone intravitreal implant (DEX) and ranibizumab. Patients who received concurrent DEX and ranibizumab injections with a follow-up period of at least three months were enrolled in the study group. An age and gender-matched group received ranibizumab injections and was designated the control group. The best-corrected visual acuity (BCVA), central macular thickness (CMT) and intraocular pressure (IOP) were included in the analysis. Steroid-induced ocular hypertension (SIOH) is defined as either an elevation of more than 10 mmHg from baseline or a single IOP measurement of more than 30 mmHg. A total of 26 patients were enrolled in the current study with 13 patients in each group. Both the BCVA and CMT achieved significant improvement after the follow-up period in the study group. The IOP increased after the injection but no significant elevation was observed throughout the follow-up period in the study group. For SIOH, one patient in the study group had an elevated IOP of 10 mmHg at two postoperative months, and no single IOP measurement of more than 30 mmHg was obtained. Five patients in the study group received medical treatment that successfully retarded their IOP elevation, and no individuals required surgical management. In the control group, there were no significant fluctuations concerning BCVA, CMT, and IOP, and no ocular hypertension was observed. According to the inter-group analysis, the CMT and BCVA recovered more significantly in the study group than in the control group. Concurrent injection of DEX and ranibizumab is a preliminary method that shows effectiveness in treating ME. Furthermore, safety is also guaranteed, with moderate levels of severity and transient IOP elevation being observed. A future large scale study is necessary to evaluate the long-term effects and safety of this combined treatment.
