视网膜分支静脉阻塞继发黄斑水肿患者康柏西普治疗前后视网膜微循环变化的研究  

Retinal microcirculation changes in patients with secondary macular edema caused by branch retinal vein occlusion before and after intravitreal conbercept injection

作　　者：夏洋 邹茜 邓国华[1] Xia Yang;Zou Xi;Deng Guohua(Department of Ophthalmology,Changzhou Municipal Third People's Hospital,Changzhou 213000,China)

机构地区：[1]常州市第三人民医院眼科,常州213000

出　　处：《中华眼外伤职业眼病杂志》2024年第4期277-282,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：江苏省老年健康科研项目(LKM2022052)。

摘　　要：目的应用光学相干断层扫描血管成像技术(OCTA)分析视网膜分支静脉阻塞(BRVO)继发黄斑水肿(ME)患者行康柏西普玻璃体内注射治疗前后视网膜血流的变化。方法回顾性病例对照研究。纳入常州市第三人民医院2019年1月至2021年1月BRVO继发ME(BRVO-ME)82例(82眼)。根据荧光素眼底血管造影(FFA)检查结果分为两组,非缺血组40例(40眼);缺血组42例(42眼)。患者双眼均行最佳矫正视力(BCVA)和OCTA检查,测量治疗前后中心凹无血管区域(FAZ)面积、浅层毛细血管网(SCP)和深层毛细血管网(DCP)的血流密度。所有患者采用1+按需治疗(PRN)进行康柏西普玻璃内注射。对比观察治疗前后上述指标的变化情况。Pearson相关性分析远期视力与治疗前后黄斑区微循环参数的相关性。结果非缺血组治疗前黄斑区FAZ和DCP血流密度分别为(0.35±0.12)mm 2和(39.77±3.66)%,治疗后黄斑区FAZ和DCP血流密度分别为(0.31±0.12)mm 2和(38.76±10.02)%,黄斑区FAZ显著缩小(t=10.12,P<0.001),DCP血流密度无变化,差异无统计学意义(t=0.82,P=0.415)。缺血组治疗前FAZ和DCP血流密度分别为(0.36±0.11)mm 2和(39.07±2.62)%,治疗后FAZ和DCP血流密度分别为(0.43±0.09)mm 2和(39.90±3.25)%,患眼FAZ明显扩大(t=-13.88,P<0.001),DCP血流密度和治疗前比较差异无统计学意义(t=-0.96,P=0.343)。非缺血组注药次数为(3.65±1.81)次,缺血组注药次数为(4.55±2.10)次,差异有统计学意义(t=-2.08,P=0.041)。结论康柏西普治疗缺血型和非缺血型BRVO-ME均可提高视力、改善微循环血流状态,减轻黄斑水肿。非缺血型BRVO-ME较缺血型效果更好。ObjectiveTo evaluate the retinal capillary alternations before and after intravitreal injection of conbercept in patients with secondary macular edema(ME)caused by branch retinal vein occlusion(BRVO)of ischemic and non ischemic types using optical coherence tomography angiography(OCTA).MethodsThis was a retrospective case control study.A total of 82 cases(82 eyes)of secondary ME of deficient or non deficient BRVO(BRVO-ME)from Jan.2019 to Jan.2021 in the Third People’s Hospital of Changzhou were included.There were 18 males and 22 females in the non ischemic group,and 24 males and 18 females in the ischemic group.All patients underwent best corrected visual acuity(BCVA)and OCTA examinations.Area of the foveal avascular zone(FAZ),superficial capillary plexus(SCP),and deep capillary plexus(DCP)were measured before and after treatment.All patients received treatment of 1+pro re nata(PRN)for intravitreal injection of conbercept.The changes in the above indicators before and after treatment were compared and observed.Pearson correlation analysis of the correlation between long-term vision and microcirculation parameters in the macular area before and after treatment were applied.ResultsBefore treatment,FAZ and DCP in the macular area of the non ischemic group were(0.35±0.12)mm 2 and(39.77±3.66)%,respectively.After treatment,FAZ and DCP in the macular area were(0.31±0.12)mm 2 and(38.76±10.02)%,respectively.FAZ in the macular area significantly reduced(t=10.12,P<0.001),and there was no change in DCP blood flow density,with no statistically significant difference(t=0.82,P=0.415).Before treatment,FAZ and DCP of the ischemic group were(0.36±0.11)mm 2 and(39.07±2.62)%,respectively.After treatment,FAZ and DCP were(0.43±0.09)mm 2 and(39.90±3.25)%,respectively.FAZ of the affected eye was significantly enlarged(t=-13.88,P<0.001),and there was no statistically significant difference in DCP blood flow density compared to that before treatment(t=-0.96,P=0.343).The average number of drug injections was(3.65±1.81)times in

关 键 词：视网膜静脉闭塞 血管内皮生长因子类 康柏西普 密度 血流 黄斑区 光学相干断层扫描血管成像 

分 类 号：R774.1[医药卫生—眼科]