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  

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

作　　者：李佳[1] 张雪彤[1] 王继红 LI Jia;ZHANG Xue-tong;WANG Ji-hong(Department of Ophthalmology,Affiliated Hospital of Jiangnan University,Wuxi 214062,China)

机构地区：[1]江南大学附属医院眼科

出　　处：《眼科》2019年第6期454-457,共4页Ophthalmology in China

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。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.

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 

分 类 号：R73[医药卫生—肿瘤]