目的：观察地塞米松玻璃体内植入剂(IDI)治疗非感染性葡萄膜炎(NIU)顽固性黄斑水肿的有效性及安全性。

方法：选取2018-04/2020-06在新疆军区总医院北京路医疗区眼科确诊的NIU患者25例30眼，均进行玻璃体腔注射IDI治疗，观察治疗前后最佳矫正视力(BCVA)、黄斑中心凹视网膜厚度(CMT)、玻璃体混浊程度评分及并发症等情况。

结果：首次玻璃体腔注射IDI治疗前，纳入患者BCVA(LogMAR)为0.76±0.37，CMT为480.03±96.72μm，玻璃体混浊程度评分为3.06±0.78分； 治疗后1、3、6mo，BCVA分别为0.61±0.24、0.53±0.10、0.40±0.13，均较治疗前明显改善(P<0.05)，CMT分别为324.54±79.88、245.16±67.87、185.52±36.05μm，较治疗前明显降低(P<0.05)，玻璃体混浊程度评分分别为2.31±0.64、1.37±0.76、0.82±0.42分，均较治疗前明显降低(P<0.05)。平均随访8.2±2.1mo，6眼眼压升高，经降眼压治疗后末次随访时处于正常范围； 3眼玻璃体腔重复注射IDI； 所有患者均无感染性眼内炎等并发症发生。

结论：玻璃体腔注射IDI治疗NIU继发的顽固性黄斑水肿具有良好的安全性及有效性，可有效降低CMT，减轻玻璃体炎症，改善视力。

METHODS: A total of 25 cases(30 eyes)of NIU patients diagnosed in the Department of Ophthalmology, Xinjiang Military District General Hospital of Chinese People's Liberation Army from April 2018 to June 2020 were selected and all were treated with vitreous cavity injection IDI to observe the best corrected visual acuity(BCVA), central macular thickness(CMT), vitreous opacities score and complications before and after treatment.

RESULTS: The BCVA(LogMAR)of the included patients was 0.76±0.37, CMT was 480.03±96.72 μm, and vitreous opacities score was 3.06±0.78 before the first vitreous cavity injection of IDI; After treatment at 1, 3, and 6mo, BCVA was 0.61±0.24, 0.53±0.10, and 0.40±0.13, respectively, which was significantly better than that before treatment(P<0.05), CMT was 324.54±79.88, 245.16±67.87, and 185.52±36.05μm, respectively, which was significantly lower than that before treatment(P<0.05), and vitreous opacity score was 2.31±0.64, 1.37±0.76, and 0.82±0.42, respectively, which was all significantly lower than that before treatment(P<0.05). The mean follow-up was 8.2±2.1mo, with elevated intraocular pressure(IOP)in 6 eyes, which was in the normal range at the last follow-up after IOP-lowering treatment; IDI was repeatedly injected in the vitreous cavity of 3 eyes; No complications such as infectious endophthalmitis occurred in all patients.

CONCLUSION: The vitreous cavity injection of IDI has good safety and effectiveness in treating intractable macular edema secondary to NIU, which can effectively reduce CMT, reduce vitreous inflammation and improve visual acuity.