抗血管内皮生长因子药物治疗对视网膜静脉阻塞合并黄斑水肿患眼脉络膜厚度的影响  

The influence of the choroidal thickness of the affected eye about anti-vascular endothelial growth factor drug treatment for retinal vein occlusion with macular edema

作　　者：付燕[1] 杨娜[1] 李丽英[1] 温晓英[1] 顾朝辉[1] 张月玲[1] Fu Yan;Yang Na;Li Liying;Wen Xiaoying;Gu Zhaohui;Zhang Yueling(The Second Department of Ophthalmology,The First Central Hospital of Baoding of Hebei Province,Baoding 071000,China)

机构地区：[1]河北省保定市第一中心医院眼二科,071000

出　　处：《中华眼底病杂志》2021年第9期681-686,共6页Chinese Journal of Ocular Fundus Diseases

基　　金：保定市科技计划项目(1941ZF048)。

摘　　要：目的观察玻璃体腔注射抗血管内皮生长因子(VEGF)药物治疗对视网膜静脉阻塞(RVO)合并黄斑水肿(ME)患眼中心凹下脉络膜厚度(SFCT)的影响。方法前瞻性临床研究。2017年1月至2019年1月于保定市第一中心医院眼科检查确诊的单眼RVO-ME患者59例59只眼纳入研究。其中,男性31例31只眼,女性28例28只眼;平均年龄(57.4±10.3)岁。病程5 d~ 1个月,均为初次发病者。视网膜分支静脉阻塞(BRVO)35只眼(BRVO-ME组),非缺血型视网膜中央静脉阻塞(CRVO)24只眼(CRVO-ME组)。所有患眼均行最佳矫正视力(BCVA)、频域光相干断层扫描(OCT)检查。BCVA检查采用国际标准视力表进行,统计时换算为最小分辨角对数(logMAR)视力。采用德国Carl Zeiss公司Cirrus HD-OCT 5000仪测量患眼黄斑中心凹厚度(CMT)及双眼SFCT。所有患眼均行玻璃体腔注射抗VEGF药物治疗。治疗后随访时间6个月,对比观察治疗前及治疗后2周,1、3、6个月患眼BCVA、CMT、SFCT变化,以及与治疗相关的并发症发生情况。治疗前及治疗后不同时间BCVA、CMT、SFCT比较采用重复测量方差分析;不同时间点差异的两两比较采用最小显著差法t检验。结果治疗前,RVO-ME患眼平均logMAR BCVA、CMT分别为0.92±0.46、(604.71±169.35)μm。治疗后2周,1、3、6个月,患眼BCVA较治疗前明显改善,CMT明显下降,差异有统计学意义(F=55.664、59.518,P<0.05)。治疗前,RVO-ME患者患眼、对侧健康眼平均SFCT分别为(306.3±65.8)、(241.3±59.8)μm;患眼SFCT较对侧健康眼明显增厚,差异有统计学意义(t=25.772,P<0.05 )。治疗后2周,1、3、6个月,患眼平均SFCT分别为(267.7±81.4)、(252.3±57.3)、(239.2± 46.5 )、(240.6±48.3)μm;与治疗前比较,治疗后不同时间SFCT明显下降,差异有统计学意义(F= 924.341,P<0.001)。CRVO-ME组、BRVO-ME组患眼治疗后2周,1、3、6个月SFCT比较,差异均无统计学意义(P>0.05 )。所有患眼随访期间均未发生眼内炎、白内障进展和Objective To observe the effect of intravitreal injection of anti-vascular endothelial growth factor drugs on the subfoveal choroid thickness(SFCT)of patients with retinal vein occlusion(RVO)and macular edema(ME).Methods A prospective clinical study.From January 2017 to January 2019,59 monocular RVO-ME patients with 59 eyes diagnosed in the eye examination of The First Central Hospital of Baoding were included in the study.Among them,there were 31 males with 31 eyes and 28 females with 28 eyes;the average age was 57.4±10.3 years old.The course of the disease was 5 days to 1 month,all of whom had the first-onset disease.Branch retinal vein occlusion(BRVO)was found in 35 eyes(BRVO-ME group);nonischemic central retinal vein occlusion(CRVO)was found in 24 eyes(CRVO-ME group).Best corrected visual acuity(BCVA)and frequency domain optical coherence tomography(OCT)were performed.The BCVA examination was carried out using the international standard visual acuity chart,which was converted into the logarithmic minimum angle of resolution(logMAR)visual acuity during statistics.The Cirrus HD-OCT 5000 instrument from Carl Zeiss company of Germany was used to measure the central macular thickness(CMT)and SFCT.All eyes were treated with intravitreal injection of anti-vascular endothelial growth factor drugs.The follow-up time after treatment was 6 months,and the changes of BCVA,CMT and SFCT of eyes before treatment and 2 weeks after treatment were compared and observed,as well as the occurrence of treatment-related complications.The comparison of BCVA,CMT,and SFCT at different times before and after treatment were adopted repeated measures analysis of variance;pairwise comparison of differences at different time points adopts the least significant difference t test.Results Before treatment,the average logMAR BCVA and CMT of RVO-ME eyes were 0.92±0.46 and 604.71±169.35 μm,respectively.At 2 weeks,1,3,and 6 months after treatment,the average logMAR BCVA of the affected eye was significantly improved compared with that before t

关 键 词：视网膜静脉闭塞 黄斑水肿 脉络膜厚度 

分 类 号：R774[医药卫生—眼科]