SS-OCT在不同肾功能状态DME患者抗VEGF疗效评价中应用分析  

Application and Analysis of SS-OCT/OCTA in the Evaluation of Anti-VEGF Efficacy in DME Patients with Different Renal Function States

作　　者：李天柔 梁莉聪 乐源 蒋萌 赵媛 陆方[1] LI Tian-rou;LIANG Li-cong;LE Yuan;JIANG Meng;ZHAO Yuan;LU Fang(Department of Ophthalmology,West China Hospital,Sichuan University,Chengdu,Sichuan,610000,China;Mianyang Hospital Affiliated to University of Electronic Science and Technology of China Medical College·Mianyang Central Hospital,Mianyang,Sichuan,621000,China)

机构地区：[1]四川大学华西医院眼科,四川成都610000 [2]电子科技大学医学院附属绵阳医院·绵阳市中心医院,四川绵阳621000

出　　处：《现代生物医学进展》2023年第12期2257-2262,共6页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(81570863);四川省科技厅科技支撑计划项目(2016SZ0024)。

摘　　要：目的:探讨扫频源光学相干层析成像(SS-OCT)在不同肾功能状态糖尿病黄斑水肿(DME)患者抗血管内皮生长因子(VEGF)治疗疗效的应用价值。方法:选择2020年1月至2022年1月我院收治的80例DME患者,根据尿白蛋白含量将患者分为正常蛋白尿组(35例,<30 mg),微量蛋白尿组(28例,30~300 mg)和大量蛋白尿组(17例,>300 mg)。所有患者均接受抗VEGF治疗,比较不同肾功能状态临床疗效差异,SS-OCT技术测量治疗前后黄斑区中央视网膜厚度(CRT)、中心凹无血管区(FAZ)面积、FAZ周长、中心凹旁300μm血流密度(FD-300)、旁中心凹浅层及深层视网膜血流密度的变化。结果:大量蛋白尿组治疗总有效率低于正常蛋白尿组、微量蛋白尿组(35.29%vs 60.71%、85.71%,P<0.05)。三组治疗后CRT、FAZ面积、FAZ周长均较治疗前降低(P<0.05),FD-300、旁中心凹浅层血流密度、深层血流密度均较治疗前增加(P<0.05)。大量蛋白尿组治疗前、后CRT、FAZ面积、FAZ周长大于正常蛋白尿组、微量蛋白尿组(P<0.05),且微量蛋白尿组大于正常蛋白尿组(P<0.05);大量蛋白尿组治疗前、后FD-300、旁中心凹浅层血流密度、深层血流密度低于正常蛋白尿组、微量蛋白尿组(P<0.05),且微量蛋白尿组低于正常蛋白尿组(P<0.05)。结论:SS-OCT可准确定量评估不同肾功能状态DME患者抗VEGF治疗前后CRT、FAZ形态以及血流灌注的变化,可用于评估抗VEGF疗效。Objective:To investigate the application value of frequency scanning optical coherence tomography(SS-OCT)in the anti-vascular endothelial growth factor(VEGF)treatment of diabetic macular edema(DME)in different renal function states.Methods:80 DME patients admitted to our hospital from January 2020 to January 2022 were selected.According to the urinary albumin content,patients were divided into normal proteinuria group(35 cases,<30 mg),microproteinuria group(28 cases,30-300 mg)and macroproteinuria group(17 cases,>300 mg).All patients received anti-VEGF therapy,and the clinical efficacy differences of different renal function states were compared.The changes of central retinal thickness(CRT)in macular area,vascularless area in fovea(FAZ),FAZ circumference,300μm parafotal blood flow density(FD-300),superficial and deep retinal blood flow density in parafotal foveal area were measured by SS-OCT technique before and after treatment.Results:The total effective rate of massive proteinuria group was lower than that of normal proteinuria group and microproteinuria group(35.29%vs 60.71%,85.71%,P<0.05).After treatment,CRT,FAZ area and FAZ circumference in three groups were decreased compared with before treatment(P<0.05),FD-300,superficial and deep blood flow density in para-fovea were increased compared with before treatment(P<0.05).Before and after treatment,the CRT,FAZ area and FAZ circumference of the proteinuria group were higher than those of normoalbuminuria group and microproteinuria group(P<0.05),and the microproteinuria group was higher than that of normoalbuminuria group(P<0.05).After treatment,FD-300,para-fovea superficial and deep blood flow density in the proteinuria group were lower than those in the normoproteinuria group and the microproteinuria group(P<0.05),and the microproteinuria group was lower than the normoproteinuria group(P<0.05).Conclusion:SS-OCT can accurately and quantitatively evaluate the changes of CRT,FAZ morphology and blood perfusion in DME patients with different renal function states be

关 键 词：扫频源光学相干层析成像 糖尿病黄斑水肿 血管内皮生长因子 疗效 

分 类 号：R587.2[医药卫生—内分泌] R774[医药卫生—内科学]