地塞米松玻璃体植入剂应用进展

地塞米松玻璃体植入剂(DEX)是一种装载0.7mg地塞米松的可生物降解的缓释植入物，其适应证主要有视网膜静脉阻塞继发黄斑水肿(RVO-ME)、糖尿病黄斑水肿(DME)和非感染性葡萄膜炎(NIU)。DEX的应用中不良事件主要有眼压升高和白内障，也正因此DEX在RVO-ME、DME的治疗中属于二线用药，多在抗血管内皮生长因子(VEGF)治疗无应答时使用，但DEX在人工晶状体眼或不愿频繁注药的患者中能发挥出其特定的优势。近来很多研究证实了DEX治疗NIU的有效性和安全性，但其在NIU治疗中的地位尚不明确。本文综述了DEX相关的重大临床试验结果，分析其应用进展和安全性。

Process in the application of dexamethasone vitreous implant

Dexamethasone intravitreal implant is a biodegradable dexamethasone(DEX)0.7mg slow-release implant that progressively dissolves in the vitreous gel. DEX implant now is approved for macular edema(ME)secondary to retinal vein occlusion(RVO), diabetic macular edema(DME)and non-infectious uveitis(NIU). The most common treatment-emergent adverse events are intraocular pressure(IOP)elevation and cataract. Therefore, DEX implant is still second choice level in treatment of RVO-ME and DME. It is reasonable to switch to DEX implant when anti-vascular endothelial growth factor(VEGF)therapy fail. However, DEX implant may be recommended as a first choice for selected cases, such as for pseudophakic eyes, anti-VEGF-resistant eyes, or patients reluctant to receive intravitreal injections frequently. Recent studies suggest dexamethasone implant is safely and effectively improves uveitis-related ME but the role of DEX implant in the management of NIU has yet to be defined. This article reviews the recent progress of DEX implant and focusing on its efficacy and safety.