视网膜分支静脉阻塞抗VEGF治疗患者脉络膜血管指数的变化及其临床意义  

Changes and clinical significance of choroidal vascular index in patients with branch retinal vein occlusion treated with anti-VEGF

作　　者：王少龙 孙艳 侯宁 高丽煜 邓爱军[2] WANG Shaolong;SUN Yan;HOU Ning;GAO Liyu;DENG Aijun(Clinical Medical College of Weifang Medical University,Weifang 261000,China;不详)

机构地区：[1]潍坊医学院临床医学院,山东潍坊261000 [2]潍坊医学院附属医院眼科

出　　处：《山东医药》2022年第28期34-37,共4页Shandong Medical Journal

基　　金：山东省自然科学基金面上项目(ZR2020MH173);潍坊市潍坊医学院附属医院博士课题(2020BSQD05)。

摘　　要：目的探讨视网膜分支静脉阻塞(BRVO)患者抗血管内皮生长因子(VEGF)治疗前后脉络膜血管指数(CVI)的变化及意义。方法选取诊断为单眼BRVO患者50例(50只眼),向玻璃体腔缓慢注射抗VEGF药物雷珠单抗注射液0.05 mL(含雷珠单抗0.5 mg);治疗前及治疗后1个月分别进行视力表、OCT检查,检测最佳矫正视力(BCVA),测量黄斑中央凹1500μm范围中心凹厚度(CMT)、中心凹下脉络膜厚度(SFCT)以及脉络膜血管指数(CVI)。另取年龄、性别等相匹配的正常人50例作为对照组。结果治疗前BRVO组CVI为(67.38±5.92)%、CMT为(531.35±171.32)μm、SFCT为(269.65±55.25)μm,对照组分别为(61.58±1.26)%、(231.18±18.31)μm、(234.55±37.87)μm;两组CVI、CMT比较差异有统计学意义(P均<0.05),两组SFCT比较差异无统计学意义(P>0.05)。BRVO患者治疗前BCVA为0.30±0.23,抗VEGF后1个月BCVA为0.50±0.35,治疗后BCVA明显改善(P<0.05)。BRVO患者治疗后CVI(60.52±3.14)%、CMT(296.40±113.05)μm、SFCT(223.45±18.35)μm,与治疗前比较差异有统计学意义(P均<0.05)。CVI变异系数(CV)为8.79%,SFCT的CV为20.50%,与SFCT比较,CVI的CV低。结论BRVO抗VEGF治疗后CVI减小;且CVI相对SFCT变化波动性小,更适合作为BRVO短期治疗的预后生物标志物。Objective To investigate the changes and significance of choroidal vascular index(CVI)in patients with branch retinal vein occlusion(BRVO)before and after anti-vascular endothelial growth factor(VEGF)treatment.Methods Fifty patients(50 eyes)with monocular BRVO were slowly injected with anti-VEGF drug ranibizumab injections 0.05 mL(including ranibizumab 0.5 mg)into the vitreous cavity.Before treatment and 1 month after treatment,visual acuity chart and OCT were performed to detect the best corrected visual acuity(BCVA)and measure the central macular thickness within 1500μm(CMT),subfoveal choroidal thickness(SFCT),and choroidal vascular index(CVI).Another 50 normal persons matched with age and sex were selected as the control group.Results Before treatment,CVI,CMT and SFCT in the BRVO group were 67.38%±5.92%,(531.35±171.32)μm and(269.65±55.25)μm,while those in the control group were 61.58%±1.26%,(231.18±18.31)μm and(234.55±37.87)±m,respectively.There were significant differences in CVI and CMT between the two groups(both P<0.05),but there was no significant difference in SFCT between the two groups(P>0.05).The BCVA of BRVO patients was 0.30±0.23 before treatment,and BCVA was 0.50±0.35 at 1 month after anti-VEGF treatment.BCVA was significantly improved after treatment(P<0.05).CVI in BRVO patients after treatment was 60.52%±3.14%,CMT was(296.40±113.05)μm and SFCT was(223.45±18.35)μm,and significant differences were found in comparison with those before treatment(P<0.05).The coefficient of variation(CV)of CVI was 8.79%.The CV of CVI was 20.50%.Compared with SFCT,the CV of CVI was lower.Conelusions After BRVO patients are treated with anti-VEGF,CVI decreases,but CVI fluctuates less in comparison with SFCT.Compared with SFCT,CVI is more effective as a prognostic biomarker for short-term treatment of BRVO.

关 键 词：视网膜分支静脉阻塞 脉络膜血管指数 血管内皮生长因子 中心凹下脉络膜厚度 

分 类 号：R774.1[医药卫生—眼科]