应用OCTA评估老年性黄斑病变患者抗VEGF治疗的疗效  

Evaluation on efficacy of anti-VEGF therapy for age-related macular degeneration using OCTA

作　　者：李莉[1] 陈晓凯[1] 李湧 Li Li;Chen Xiaokai;Li Yong(Department of Ophthalmology,Pingdingshan First People’s Hospital,Pingdingshan 467000,China;Department of Ophthalmology,Pingdingshan Ophthalmology Hospital,Pingdingshan 467000,China)

机构地区：[1]平顶山市第一人民医院眼科,平顶山467000 [2]平顶山眼科医院眼科,平顶山467000

出　　处：《中国实用医刊》2024年第19期19-22,共4页Chinese Journal of Practical Medicine

摘　　要：目的观察应用光学相干断层扫描血管成像术(OCTA)评估老年性黄斑病变抗血管内皮生长因子(VEGF)治疗的疗效。方法回顾性抽取2021年1月到2022年6月在平顶山市第一人民医院接受抗VEGF治疗的70例老年性黄斑病变患者,评估所有患者最佳矫正视力(BCVA)、中心黄斑厚度(CMT);使用OCTA评估治疗前后患者脉络膜新生血管(CNV)特征[CNV面积、最大线性尺寸(GLD)、高度、密度]。结果治疗后,患者BCVA[(0.46±0.28)LogMAR]低于治疗前[(0.93±0.42)LogMAR],CMT[(214.17±69.11)μm]低于治疗前[(362.83±145.25)μm],差异有统计学意义(P<0.05);患者接受抗VEGF治疗后CNV面积、CNV、GLD、CNV高度和CNV密度均低于治疗前(P均<0.05);治疗后活动性CNV病变的检出率低于治疗前,且OCTA与OCT检查在评估活动性病变方面一致性良好(P<0.05)。活动性病变患者经过抗VEGF治疗后的BCVA提高率、CMT降低率、CNV面积降低率、CNV密度降低率均高于非活动性病变患者(P均<0.05)。结论OCTA是评估AMD患者接受抗VEGF治疗疗效的一个有效工具,其在未来的临床应用中可作为一个重要的监测手段。ObjectiveTo observe the efficacy of anti-vascular endothelial growth factor(VEGF)therapy for age-related macular degeneration(AMD)using optical coherence tomography angiography(OCTA).MethodsSeventy patients with AMD who received anti-VEGF therapy in Pingdingshan First People’s Hospital from January 2021 to June 2022 were retrospectively selected.Best corrected visual acuity(BCVA)and central macular thickness(CMT)in all selected patients were evaluated.OCTA was used to assess the characteristics of choroidal neovascularization(CNV),including CNV area,greatest linear dimension(GLD),height,and density before and after treatment.ResultsAfter treatment,BCVA significantly decreased from(0.93±0.42)LogMAR to(0.46±0.28)LogMAR,and CMT significantly decreased from(362.83±145.25)μm to(214.17±69.11)μm;and the differences between preoperative and postoperative values of the two indicators were statistically significant(P<0.05).After anti-VEGF therapy,the CNV area,CNV GLD,CNV height,and CNV density all decreased,with significant difference in comparison with preoperative values(P<0.05).Additionally,the postoperative detection rate of active CNV lesions were significantly lower than the preoperative detection rate,and OCTA showed good consistency with OCT in evaluating active lesions(P<0.05).Patients with active lesions had significantly higher increase ratio of BCVA,reduction ratio of CMT,reduction ratio of CNV area,and reduction ratio of CNV density compared with patients with inactive lesions(all P<0.05).ConclusionsOCTA is an effective tool for evaluating the efficacy of anti-VEGF therapy in patients with AMD,and it can serve as an important monitoring method in future clinical applications.

关 键 词：黄斑病变 光学相干断层扫描血管成像术 抗血管内皮生长因子 脉络膜新生血管 

分 类 号：R774.5[医药卫生—眼科]