OCTA与MAIA微视野计对康柏西普治疗视网膜分支静脉阻塞性黄斑水肿的疗效评估  

Efficacy of conbercept in the treatment of macular edema secondary to branch retinal vein occlusion evaluated by OCTA and MAIA microperimetry

作　　者：胡茫[1] 邵杨杨 吴超琼[1] 朱晶[1] 肖泽锋 HU Mang;SHAO Yangyang;WU Chaoqiong;ZHU Jing;XIAO Zefeng(Dept.of Ophthalmology,Wuhan No.1 Hospital,Wuhan 430022,Hubei,China)

机构地区：[1]武汉市第一医院眼科,湖北武汉430022

出　　处：《武汉大学学报（医学版）》2023年第1期111-114,120,共5页Medical Journal of Wuhan University

基　　金：武汉市卫健委科研项目面上项目(编号:WX18D46)。

摘　　要：目的:探讨视网膜分支静脉阻塞(BRVO)继发黄斑水肿(ME)患者抗血管内皮生长因子(VEGF)治疗前后黄斑区视网膜血流参数的变化及微视野计在黄斑区视功能评估的应用价值。方法:选取2019年1—12月武汉市第一医院收治的BRVO继发ME的病人41例41眼,所有病眼均接受抗VEGF治疗,药物为康柏西普。注射前和注射后6月,所有病人均接受最佳矫正视力(BCVA)检查、光相干断层扫描血管成像检查(OCTA)和黄斑完整性评估仪(MAIA)微视野计检查。记录治疗前后中心凹视网膜厚度(CMT)、黄斑中心凹无血管区(FAZ)面积、浅层视网膜毛细血管丛(SCP)和深层视网膜毛细血管丛(DCP)的平均血流密度(VD)、黄斑区视网膜平均敏感度(RMS)、2°固视率(P1)、4°固视率(P2)。采用配对t检验法分析治疗前后各项资料的差异,采用Spearman相关分析法分析治疗后logMAR BCVA与RMS、P1、P2的相关性。结果:与治疗前比较,康柏西普注射6月后,BCVA显著提升(P<0.05),CMT显著降低(P<0.05);黄斑区SCP VD、DCP VD、FAZ面积较治疗前无显著差异(P>0.05);RMS、P1显著提升(P<0.05),P2较治疗前无显著差异(P>0.05);logMAR BCVA与RMS、P1、P2呈负相关。结论:BRVO继发ME经抗VEGF治疗后黄斑区视网膜血流参数无显著变化;RMS、P1、P2可作为评价黄斑区视功能的良好指标。Objective:To investigate the changes of retinal blood flow parameters in macular area after anti⁃vascular endothelial growth factor(VEGF)therapy in patients with macular edema(ME)secondary to branch retinal vein occlusion(BRVO)and the value of microperimetry in estimating visual function of macula.Methods:Forty⁃one patients with ME secondary to BRVO in Wuhan No.1 Hospital from January 2019 to December 2019 were selected.All patients were received the injection of Conber⁃cept.The best corrected visual acuity(BCVA),optical coherence tomography angiography(OCTA),and Macular Integrity Assessment(MAIA)microperimetry were performed before the injection and six months after the injection.The changes in central macular thickness(CMT),foveal avascular area(FAZ),vessel density(VD)of superficial capillary plexus(SCP),deep capillary plexus(DCP),macular retinal mean sensitivity(RMS),2°fixation rate(P1),and 4°fixation rate(P2)before and after treat⁃ment were measured.Paired t⁃test was used to analyze the differences in various data before and after treatment,and Spearman's correlation method was used to analyze the correlation between logMAR BCVA and RMS,P1,or P2.Results:Six months afer the treatment,the BCVA increased notably(P<0.05)while the CMT decreased notably(P<0.05),but there were no significant changes in SCP,DCP,and FAZ after treatment(P>0.05).The RMS and P1 increased notably(P<0.05),but there were no significant changes in P2 after treatment(P>0.05).There was negative correlation between logMAR BCVA and RMS,P1,or P2.Conclusion:There was no changes of retinal blood flow parameters in macular area after anti⁃VEGF therapy in patients with ME secondary to BRVO.RMS,P1,and P2 are good indicators for macular function.

关 键 词：OCTA MAIA微视野计 视网膜分支静脉阻塞 黄斑水肿 康柏西普 

分 类 号：R774.5[医药卫生—眼科]