因血一视网膜屏障的存在,玻璃体视网膜疾病的给药方法常受到限制,玻璃体腔内注射药物直接作用于玻璃体和视网膜,是其有效治疗方法,但对慢性反复发作性疾病,需频繁注射以达到有效药物浓度。玻璃体腔内植入装置既避开了血一视网膜屏障,又延长了药物的作用时间,是治疗玻璃体视网膜疾病的新方法,因其装载的药物不同而治疗不同的疾病。抗病毒药物植入装置能有效治疗获得性免疫缺陷综合征患者的巨细胞病毒性视网膜炎。激素类植入装置能有效治疗眼底慢性炎性疾病如黄斑水肿、非感染性葡萄膜炎,主要副作用为眼压升高和白内障形成。睫状神经营养因子和抗血管内皮生长因子植入装置可能是老年性黄斑变性的有效治疗药物。本文将综述目前常见的玻璃体腔内植入装置在玻璃体视网膜疾病中的临床应用。
Due to blood-retinal barrier, drug administration is often limited for the treatment of vitreoretinal disorders. Intravitreal drug injection is an effective method as it can directly deliver drugs to act on vitreous body and retina. However, for chronic and recurrent diseases, injection needs to be repeated frequently to achieve effective drug concentration. Ocular implants, which not only avoid blood-retinal barrier but also extent action time, have become a new treatment for vitreoretinal disorders. Different implants can treat different diseases. Antiviral drug implant can be effective in the treatment of cytomegalovirus retinitis for the acquired immunodeficiency syndrome patients. Steroid implant can be effective in the treatment of chronic inflammatory fundus diseases such as macular edema and noninfectious uveitis. The main side effects were elevated intraocular pressure and cataract formation. Ciliary neurotrophic factor and anti- vascular endothelial growth factor implants may be the effective drugs for the treatment of age- related macular degeneration. This article reviewed the clinical applications of current major intravitreal implants on vitreoretinal disorders.