视网膜静脉阻塞患者抗血管内皮生长因子治疗后视力差的影响因素  

Factors influencing poor visual outcomes in patients with retinal vein occlusion after anti-vascular endothelial growth factor therapy

作　　者：杨婷婷[1] 刘家艳[1] 曾凤[1] 卢亚梅[1] YANG Ting-ting;LIU Jia-yan;ZENG Feng;LU Ya-mei(Department of Ophthalmology,Affiliated Qingyuan Hospital,Guangzhou Medical University,Qingyuan People′s Hospital,Qingyuan 511518,Guangdong,China)

机构地区：[1]广州医科大学附属清远医院(清远市人民医院)眼科,广东清远511518

出　　处：《广东医学》2024年第10期1337-1342,共6页Guangdong Medical Journal

基　　金：清远市社会发展领域自筹经费科技计划项目(211029104560243)。

摘　　要：目的评估视网膜静脉阻塞(RVO)患者接受抗血管内皮生长因子(VEGF)治疗后视力差的影响因素。方法以2018年6月至2023年6月期间在广州医科大学附属清远医院诊断为RVO并接受抗VEGF治疗的患者为研究对象,收集患者的眼部及临床病例资料。根据规范抗VEGF治疗后最终视力进行分组:最终logMAR最佳矫正视力(BCVA)>1为视力差组;最终视力logMAR BCVA≤1为对照组。比较视力差组与对照组患者的特征,并分析RVO患者最终视力差的危险因素。结果177名符合纳入条件的RVO患者中,最终视力差者70例,对照组107例。视力差组的年龄、中央型RVO、合并视网膜内层紊乱、合并外界膜破坏显著高于对照组(P<0.05);视力差组的基线视力、红细胞比积显著低于对照组(P<0.05)。多因素logistic回归分析显示颈动脉病变(OR=3.40,95%CI:1.22~12.44,P<0.05)、基线视力(OR=0.01,95%CI:0.00~0.005,P<0.001)、视网膜内层紊乱(OR=7.80,95%CI:2.33~26.15,P<0.05)、外界膜破坏(OR=6.87,95%CI:2.05~23.00,P<0.05)和红细胞比积(OR=1415526,95%CI:21.69~9.24×10^(10),P<0.05)与RVO患者抗VEGF后视力差显著相关。结论合并颈动脉病变、基线视力差、视网膜内层紊乱、外界膜破坏和较低的红细胞比积是RVO患者抗VEGF治疗后视力差的危险因素。Objective To evaluate the factors influencing poor visual outcomes in patients with retinal vein occlusion(RVO)after receiving anti-vascular endothelial growth factor(VEGF)therapy.Methods This study included patients diagnosed with RVO and treated with anti-VEGF therapy at Qingyuan Hospital affiliated with Guangzhou Medical University from June 2018 to June 2023.Clinical and ocular data were collected.Patients were divided into two groups based on their final best-corrected visual acuity(BCVA)in logMAR:a poor vision group(final logMAR BCVA>1)and a control group(final logMAR BCVA≤1).Characteristics of the two groups were compared,and risk factors for poor visual outcomes were analyzed.Results Among 177 patients meeting the inclusion criteria,70 were in the poor vision group and 107 were in the control group.The poor vision group had significantly higher rates of older age,central RVO,inner retinal layer disorganization,and external limiting membrane disruption(P<0.05).Baseline vision and hematocrit were significantly lower in the poor vision group(P<0.05).Multivariate logistic regression analysis showed that carotid artery disease(OR=3.40,95%CI:1.22-12.44;P<0.05),baseline vision(OR=0.01,95%CI:0.00-0.005;P<0.001),inner retinal layer disorganization(OR=7.80,95%CI:2.33-26.15;P<0.05),external limiting membrane disruption(OR=6.87,95%CI:2.05-23.00;P<0.05),and hematocrit(OR=1415526,95%CI:21.69-9.24×10^(10);P<0.05)were significantly associated with poor visual outcomes after anti-VEGF therapy in RVO patients.Conclusion Carotid artery disease,poor baseline vision,inner retinal layer disorganization,external limiting membrane disruption,and lower hematocrit are risk factors for poor visual outcomes in RVO patients after anti-VEGF therapy.

关 键 词：视网膜静脉阻塞 抗血管内皮生长因子 视力 影响因素 

分 类 号：R774.1[医药卫生—眼科] R779.62[医药卫生—临床医学]