息肉样脉络膜血管病变治疗前后光学相干断层扫描的图像特征  

Image features of optical coherence tomography before and after treatment of polypoid choroidal vasculopathy

作　　者：李文清 宋艳萍[1,2] LI Wen-Qing;SONG Yan-Ping(Wuhan Clinical College of Southern Medical University,Wuhan 430070,Hubei Province,China;the Ophthalmology Center,Wuhan General Hospital of the PLA,Wuhan 430070,Hubei Province,China)

机构地区：[1]南方医科大学附属武汉临床医学院,湖北省武汉市430070 [2]中国人民解放军武汉总医院眼科,全军眼科中心,湖北省武汉市430070

出　　处：《眼科新进展》2019年第9期849-853,共5页Recent Advances in Ophthalmology

摘　　要：目的观察玻璃体内注射康柏西普治疗息肉样脉络膜血管病变(polypoid choroidal vasculopathy,PCV)前后光学相干断层扫描(optical coherence tomography,OCT)的图像特征,并分析黄斑结构与视力的相关性。方法遵循3+PRN方案对确诊为PCV的患者31例31眼进行玻璃体内注射康柏西普治疗,随访时间≥12个月。记录治疗前后最佳矫正视力(best corrected visual acuity,BCVA)、黄斑中心凹视网膜厚度(center macular thickness,CMT)、总黄斑体积(total macular volume,TMV)、视网膜下液高度(subretinal fluid height,SRFH)、视网膜色素上皮层脱离高度(pigment epithelial detachment height,PEDH)、视网膜色素上皮层脱离面积(pigment epithelial detachment area,PEDA)及视网膜色素上皮层脱离体积(pigment epithelial detachment volume,PEDV)的变化;并以3个月为单元,对BCVA存在统计学差异的时间段进行logMAR BCVA变化量与OCT各项检测指标变化量的相关性分析。结果治疗后1个月、3个月、6个月、9个月、12个月的CMT、TMV、SRFH、PEDH、PEDA、PEDV 6项指标均较治疗前下降,差异均有统计学意义(均为P<0.05)。CMT、TMV、SRFH在治疗后3个月基本达到治疗的峰值,而PEDH、PEDA、PEDV在治疗后6个月才逐渐稳定。BCVA在治疗后3个月明显提高,治疗前与治疗后3个月BCVA相比差异有统计学意义,该时间段的△logMAR BCVA与△CMT、△SRFH、△PEDV呈正相关(r=0.456、0.381、0.475,均为P<0.05),与△TMV、△PEDH、△PEDA无相关性(均为P>0.05)。结论 3+PRN玻璃体内注射康柏西普可以在治疗后3个月有效地降低PCV患者CMT、TMV、SRFH,提高BCVA,但视网膜色素上皮脱离的恢复比视网膜内液或视网膜下液吸收慢;OCT可对PCV治疗前后各项指标的变化进行定量测量,CMT、SRFH、PEDV的下降程度反映了前3个月BCVA的提高程度。Objective To observe the image features of optical coherence tomography(OCT) before and after treatment of polypoid choroidal vasculopathy(PCV) with intravitreal injection of Conbercept,and to analyze the correlation between macular structure and visual acuity.Methods Totally 31 eyes of 31 patients diagnosed with PCV were treated with intravitreal injection of Conbercept following the 3+PRN regimen.The follow-up period was more than 12 months.The change of the best corrected visual acuity(BCVA),center macular thickness(CMT),total macular volume(TMV),subretinal fluid height(SRFH),pigment epithelial detachment height(PEDH),pigmentation epithelial detachment area(PEDA) and pigment epithelial detachment volume(PEDV) were recorded before and after treatment.Using three months as a unit,the correlation analysis between the change of logMAR BCVA and OCT test indicators were carried out for the time periods of significant differences in BCVA.Results After treatment,the CMT,TMV,SRFH,PEDH,PEDA,and PEDV indexes significantly decreased at 1 month,3 months,6 months,9 months,and 12 months compared to those before treatment,and the difference had statistical significance(all P<0.05).The CMT,TMV and SRFH nearly reached the peak after 3 months of treatment,while PEDH,PEDA and PEDV gradually stabilized after 6 months of treatment.BCVA was significantly improved after 3 months treatment,and there was a significant difference in BCVA between pre-treatment and 3 months after treatment.The △logMAR BCVA of this time period was positively correlated with △CMT,△SRFH and △PEDV(r=0.456,0.381,0.475,all P<0.05).However,no correlations were found with △TMV,△PEDH and △PEDA(all P>0.05).Conclusion 3+PRN intravitreal injection of Conbercept can effectively reduce CMT,TMV,SRFH and improve BCVA in patients with PCV after 3 months treatment,while PED decreases slower than the intraretinal or subretinal fluid;OCT can quantitatively measure the change of each index before and after the treatment of PCV.The decrease of CMT,SRFH,and PEDV r

关 键 词：康柏西普 息肉样脉络膜血管病变 光学相干断层扫描 黄斑体积 视网膜下液 

分 类 号：R773.4[医药卫生—眼科]