黄斑中心凹旁血流密度对BRVO患者玻璃体腔内康柏西普注射次数的预测作用评价  

Evaluation of the predictive effect of parafoveal blood flow density of macula on the number of intravitreal Conbercept injections in patients with branch retinal vein occlusion

作　　者：杨婷婷 赵玥 沈亚明 姚进 Ting-Ting Yang;Yue Zhao;Ya-Ming Shen;Jin Yao(The Affiliated Eye Hospital of Nanjing Medical University,Nanjing 210000,Jiangsu Province,China)

机构地区：[1]南京医科大学眼科医院,江苏省南京市210000

出　　处：《国际眼科杂志》2023年第12期2046-2051,共6页International Eye Science

摘　　要：目的:研究非缺血型视网膜分支静脉阻塞(BRVO)合并黄斑水肿(ME)患者的光学相干断层扫描血管成像(OCTA)中围绕黄斑无血管区(FAZ)区域300μm宽度内的血流密度(FD-300),探讨并评估该参数对眼内注药次数的预测作用。方法:回顾性研究,选取2021-01/2022-03于南京医科大学眼科医院诊断为非缺血型BRVO合并ME并接受了玻璃体腔内康柏西普注射(IVC)的患者50例50眼,采用3+PRN治疗方案。将眼内注药治疗≤5次的患眼列为B组(25例25眼);眼内注药治疗>5次的患眼列为C组(25例25眼),另外随机选取对侧眼作为对照组A组(25例25眼)。采用OCTA对所有患眼行黄斑区3mm×3mm范围模式扫描采集视网膜血流图像,获取黄斑中心凹下视网膜厚度(CMT)及FD-300值。比较各组基线时及第3针注射后1、3、6、12mo时的CMT、BCVA(LogMAR)、FD-300。结果:B组和C组受试者治疗后1、3、6、12mo时的患眼BCVA(LogMAR)较基线均明显改善(均P<0.05);CMT较基线均明显降低(均P<0.05);FD-300较基线降低(均P<0.05)。Pearson相关分析显示,BCVA(LogMAR)变化量与基线FD-300、CMT呈显著正相关(B组:r=0.77、0.70,均P<0.01;C组:r=0.89、0.78,均P<0.01)。眼内注药次数与基线FD-300呈显著负相关(B组:r=-0.63,P<0.01;C组:r=-0.71,P<0.01)。Logistic回归分析显示,治疗前FD-300参数是影响眼内注药次数的因素。结论:玻璃体腔注射康柏西普治疗非缺血型BRVO合并ME患者能有效减轻患眼黄斑水肿,提高患者视力,降低FD-300。基线BCVA越差以及基线FD-300越低的患眼可能需要更多的注射次数。使用OCTA观察黄斑区FD-300,可在治疗前更好地预测非缺血型BRVO合并ME患者的最终视力恢复。AIM:To investigate blood flow density within 300μm(FD-300)around the foveal avascular zone(FAZ)in optical coherence tomography angiography(OCTA)of patients with macular edema(ME)complicated with non-ischemic branch retinal vein occlusion(BRVO),and to explore and evaluate the predictive effect of this parameter on the number of intraocular drug injections.METHODS:A retrospective case study.A total of 50 patients(50 eyes)who were diagnosed as non-ischemic BRVO combined with ME and received intravitreal conbercept(IVC)in the Affiliated Eye Hospital of Nanjing Medical University from January 2021 to March 2022 were selected,and they were treated with 3+PRN regimen.The 25 cases(25 eyes)treated with intraocular injection≤5 times were classified as group B,and 25 cases(25 eyes)treated with intraocular injection>5 times were classified as group C,and 25 fellow eyes were randomly selected as control group A.OCTA was used to scan the macular area in 3mm×3mm to collect images of retinal blood flow,the central macular thickness(CMT)and FD-300.The CMT,best-corrected visual acuity(BCVA),and FD-300 were compared between the two groups at baseline,1,3,6 and 12mo after the third injection.RESULTS:The BCVA(LogMAR)of the affected eye in both groups B and C at 1,3,6 and 12mo after the third injection was significantly lower than baseline(all P<0.05);the CMT and FD-300 were significantly lower than baseline(all P<0.05).Pearson correlation analysis showed that the change of BCVA(LogMAR)was positively correlated with the baseline FD-300 and CMT(group B:r=0.77,0.70,all P<0.01;group C:r=0.89,0.78,all P<0.01).The number of intraocular injections was negatively correlated with the baseline FD-300(group B:r=-0.63,P<0.01;group C:r=-0.71,P<0.01).Logistic regression analysis showed that the FD-300 at baseline is a factor that affects the number of intraocular drug injection.CONCLUSION:IVC can effectively alleviate macular edema of the affected eye,improve visual acuity and reduce FD-300.The eyes with worse BCVA and lower FD-300 at baseline

关 键 词：视网膜分支静脉阻塞(BRVO) 黄斑水肿 康柏西普 玻璃体腔 FD-300 黄斑中心凹旁血流密度 光学相干断层扫描血管成像(OCTA) 

分 类 号：R774[医药卫生—眼科]