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抗血管内皮生长因子治疗对黄斑水肿患者脉络膜厚度的影响

李佳 张雪彤 王继红   

  1. 214062江苏无锡,江南大学附属医院眼科
  • 收稿日期:2019-06-22 出版日期:2019-11-25 发布日期:2019-12-06
  • 通讯作者: 李佳,Email: lij1979@sina.com E-mail:lij1979@sina.com

Changes of choroidal thickness in the treatment of macular edema with anti-vascular endothelial growth factor

LI Jia, ZHANG Xue-tong, WANG Ji-hong   

  1. Department of Ophthalmology, Affiliated Hospital of Jiangnan University, Wuxi 214062, China
  • Received:2019-06-22 Online:2019-11-25 Published:2019-12-06
  • Contact: LI Jia, Email: lij1979@sina.com E-mail:lij1979@sina.com

摘要:

目的 利用相干光断层扫描加强深度扫描模式(enhanced depth imaging-optical coherence tomography,EDI-OCT)评估玻璃体注射抗血管内皮生长因子(vascular endothelial growth factor, VEGF)药物治疗因糖尿病视网膜病变引起的黄斑水肿(diabetic macular edema, DME)和视网膜静脉阻塞继发的黄斑水肿(retinal vein occlusion-macular edema, RVO-ME)后黄斑中心凹下脉络膜厚度(subfoveal choroidal thickness,SFCT)的变化。设计 回顾性病例系列。研究对象 选取 2014年12月至2018年11月在江南大学附属医院眼科接受玻璃体抗VEGF药物注射术的DME者13眼和RVO-ME者15眼。方法 采用EDI-OCT测量术前和术后1、3、6个月的SFCT,评估玻璃体注射抗VEGF药物治疗DME与RVO-ME后SFCT的变化。主要指标 SFCT。结果 DME组术后1、3、6个月的SFCT值分别为(224.85±50.03)μm、(215.62±47.70)μm、(207.54±46.85)μm,均较术前[(244.54±53.62)μm]减小(P=0.0004,0.0002,0.0001);术后3、6个月的SFCT值较术后1个月减小(P=0.003,0.001);术后6个月的SFCT值较术后3个月减小(P=0.026)。RVO-ME组术后1、3、6个月的SFCT值分别为(260.67±42.29)μm、(254.33±40.54)μm、(239.73±37.08)μm均较术前[(288.13±49.26)μm]减小(P=0.0003,0.0002,0.0002);术后3个月的SFCT值较术后1个月减小(P=0.599);术后6个月的SFCT值较术后1、3个月减小(P=0.0002,0.0003)。结论 玻璃体注射抗VEGF药物治疗DME与RVO-ME后SFCT明显减小,动态监测SFCT值对发现病情变化有一定的参考价值。

关键词: 玻璃体注射, 黄斑水肿, 糖尿病视网膜病变, 视网膜静脉阻塞, 脉络膜厚度

Abstract:

Objective To evaluate the changes of subfoveal choroidal thickness after intravitreal injection of anti-vascular endovascular growth factor (VEGF) drugs for macular edema caused by diabetic retinopathy (DME) and macular edema secondary to retinal vein occlusion (RVO-ME) using optical coherence tomography enhanced depth scanning mode (EDI-OCT). Design Retrospective case series. Participants Thirteen eyes with DME and fifteen eyes with RVO-ME who underwent intravitreal anti-VEGF drug injection from December 2014 to November 2018 were selected. Methods The subfoveal choroidal thickness (SFCT) was measured by EDI-OCT before and 1, 3 and 6 months after operation to evaluate the changes of SFCT after intravitreal injection of anti-VEGF drugs for DME and RVO-ME. Main Outcome Measure SFCT. Results The value of SFCT in DME group 1, 3 and 6 months after operation was (224.85±50.03)μm, (215.62±47.70)μm, (207.54±46.85)μm respectively, and was lower than that before operation (P=0.0004, 0.0002, 0.0001); SFCT decreased in 3 and 6 months after operation compared with 1 month after operation (P=0.003, 0.001); SFCT decreased in 6 months after operation compared with 3 months after operation (P=0.026). The value of SFCT in RVO-ME group 1, 3 and 6 months after operation was (260.67±42.29)μm, (254.33±40.54)μm, (239.73±37.08)μm respectively, and was lower than that before operation (P=0.0003, 0.0002, 0.0002); SFCT decreased in 3 months after operation compared with 1 month after operation (P=0.599); SFCT decreased in 6 months after operation compared with 1, 3 months after operation (P=0.0002,0.0003). Conclusion SFCT decreased significantly after intravitreal injection of anti-VEGF drugs for DME and RVO-ME. Dynamic monitoring of SFCT values may be helpful in detecting the changes of the disease.

Key words: intravitreal injection, macular edema, diabetic retinopathy, retinal vein occlusion, choroidal thickness