SD-OCT随访观察抗VEGF药物治疗湿性年龄相关性黄斑变性的疗效分析  

Analysis of the therapeutic effect after anti-VEGF treatment in patients with wet age-related macular degeneration by spectral-domain optical coherence tomography

作　　者：邱翠 徐玥[2] 谢驰[1] 方严[1] Qiu Cui;Xu Yue;Xie Chi;Fang Yan(The First Affiliated Hospital of Anhui University of Science&Technology,The First People's Hospital of Huainan,Huainan 232000,China)

机构地区：[1]安徽理工大学第一附属医院(淮南市第一人民医院),232000 [2]安徽理工大学医学院

出　　处：《临床眼科杂志》2019年第6期530-533,共4页Journal of Clinical Ophthalmology

摘　　要：目的通过频域相干光层析扫描术(SD-OCT)随访观察抗血管内皮生长因子(VEGF)药物治疗湿性年龄相关性黄斑变性(AMD)的疗效,为制定再治疗方案提供依据。方法采用回顾性分析的方法。收集2019年4月至2019年9月安徽理工大学第一附属医院眼科确诊为湿性AMD的患者46例(46只眼),采用海德堡频域HRA+OCT系统定位黄斑中心凹部位,利用随访模式下分层测量功能分别测量46只眼抗VEGF药物治疗前、治疗后1个月黄斑中心凹视网膜总厚度及视网膜色素上皮(RPE)层厚度,并计算出黄斑中心凹视网膜神经上皮层厚度。最佳矫正视力采用标准对数视力表进行检查,并换算成LogMAR视力表数值进行统计学分析。比较治疗前后视网膜各层厚度的变化是否有统计学差异,以及视力变化与视网膜各层厚度的变化是否有相关性。结果抗VEGF药物治疗前黄斑中心凹视网膜总厚度(339.70±139.64)μm、黄斑中心凹视网膜神经上皮层厚度(232.57±100.68)μm与治疗1个月后黄斑中心凹视网膜总厚度(268.37±86.40)μm、黄斑中心凹神经上皮层厚度(189.30±55.48)μm之间的差异有统计学意义(t=2.73、2.29,均P<0.05);LogMAR视力变化与黄斑中心凹视网膜总厚度变化、黄斑中心凹神经上皮层厚度变化均有显著相关性(r=0.538、0.484,均P<0.01);治疗前黄斑中心凹RPE层厚度(107.13±105.03)μm与治疗1个月后RPE层厚度(79.06±72.43)μm的差异无明显统计学差异(t=1.08,P>0.05),且其厚度变化与视力变化的相关性也没有统计学意义(P>0.05)。结论 SD-OCT可有效评估抗VEGF药物治疗效果,帮助确定再治疗需要,可作为随访湿性AMD的重要手段。Objective To analysis of the therapeutic effect after anti-vascular endothelial growth factor(anti-VEGF) treatment in patients with wet age-related macular degeneration(wet AMD)by spectral-domain optical coherence tomography(OCT)for providing the evidence of retreatment.Methods Retrospective analysis meathod was used.Fourty-six eyes with wet AMD were collected from April 2019 to September 2019 in the first affiliated hospital of Anhui University of Science & Technology. The Heidelberg engineering Spectralis HRA+OCT can automaticly hunt the central fovea of macula and measure the thickness of each layer of macular fovea by follow-up model.We measured the total retinal thickness of macular fovea and the thickness of nerve epithelium and the thickness of retinal pigment epithelium in macular fovea before and one month after anti-VEGF treatment.The best corrected vision acuity(BCVA)was tested by standard logarithmatic visual acuity chart,and converted to LogMAR chart to analysis the statistical singnificance.Comparing if the change of the thickness of each layer of retina is statistically significant, and if the change of visual acuity is correlated with the change of retinal thickness in each layer.Results There were statistical diffferences(t = 2.73, 2.29, P < 0.05)between the total retinal thickness of macular fovea(339.70±139.64)μm, the thickness of nerve epithelium in macular fovea(232.57±100.68) μm of before anti VEGF treatment and the total retinal thickness of macular fovea(268.37±86.40)μm, the thickness of nerve epithelium in macular fovea(189.30±55.48)μm of 1 month after treatment;Between Log MAR visual acuity and changes in the total retinal thickness and in the thickness of nerve epithelium of macular fovea had significant correlations(r = 0.538, 0.484, P< 0.01);there was no statistically statistical diffferences between the thickness of retinal pigment epithelium(RPE) in macular fovea(107.13±105.03) μm of before anti VEGF treatment and the thickness(79.06± 72.43) μm of 1 month after treatment

关 键 词：湿性年龄相关性黄斑变性 频域相干光层析扫描术 抗血管内皮生长因子 疗效分析 

分 类 号：R73[医药卫生—肿瘤]