视网膜静脉阻塞继发黄斑水肿抗炎和抗VEGF治疗后SD-OCT生物标志物的观察  

Observation of SD-OCT biomarkers after anti-inflammatory and anti-VEGF treatment for macular edema secondary to retinal vein occlusion

作　　者：毕双双 戴馨[1] 崔京卫 平继花 辛贺贺 Bi Shuangshuang;Dai Xin;Cui Jingwei;Ping Jihua;Xin Hehe(Heze Medical College,2Ophthalmology Affiliated Hospital of Heze Medical College,Heze 274000,China)

机构地区：[1]菏泽医学专科学校,菏泽274000 [2]菏泽医学专科学校附属医院眼科

出　　处：《临床眼科杂志》2024年第6期495-499,共5页Journal of Clinical Ophthalmology

基　　金：2021年山东省医药卫生科技发展计划项目(202107021084)。

摘　　要：目的评估视网膜静脉阻塞继发黄斑水肿(RVOME)抗炎和抗血管内皮生长因子(VEGF)治疗后患者视功能和频域相干光层析成像术(SDOCT)生物标志物的变化,为临床选择合适的治疗方案提供依据。方法前瞻性病例研究。2019年6月至2021年11月在菏泽医学专科学校附属医院确诊的RVOME患者106例(106只眼),随机分为A、B两组,其中A组给予玻璃体腔内注射雷珠单抗治疗,B组给予玻璃体腔内注射地塞米松玻璃体腔内植入剂治疗。在基线和首次治疗后12个月记录最佳矫正视力(BCVA)、SDOCT的生物标志物和不良反应,比较两组在治疗前后BCVA、SDOCT的变化和不良反应的发生率。结果两组患者治疗后BCVA、SDOCT生物标志物均显著改善(均P<0.01),在12个月时B组患者浆液性视网膜脱离(SRD)降度改善明显优于A组,治疗后B组患者视网膜内高反射灶(HRFs)数量明显少于A组。两组比较,外界膜(ELM)、椭圆体带(EZ)、视网膜内层结构紊乱(DRIL)的变化差异均无统计学意义(均P>0.05)。两组治疗后球结膜下出血、晶状体混浊的发生率差异均无统计学意义,但B组24例患者出现眼压升高,明显高于A组。结论抗炎和抗VEGF治疗对RVOME均有效,BCVA和SDOCT生物标志物均有改善,在改善SRD方面,抗炎治疗优于抗VEGF治疗,在HRFs的数量上,抗炎和抗VEGF治疗之间没有差异。Objective To evaluate the changes in visual function and spectral domain optical coherence tomography(SD-OCT)biomarkers in patients with retinal vein obstruction secondary macular edema(RVO-ME)after antiinflammatory and anti-vascular endothelial growth factor(VEGF)treatment,and to provide evidence for clinical selection of appropriate treatment.Methods For prospective study,106 patients(106 eyes)diagnosed with RVO-ME in the Affiliated Hospital of Heze Medical College from June 2019 to November 2021 were randomly divided into two groups:A and B.Group A was given intravitreal injection of Ranibizumab,group B was given intravitreal injection of dexamethasone.Biomarkers of best corrected visual acuity(BCVA)and SD-OCT and adverse reactions were recorded at baseline and 12mo after the first treatment,and changes in BCVA and SD-OCT and incidence of adverse reactions were compared between the two groups before and after treatment.Results BCVA and SD-OCT biomarkers were significantly improved in both groups after treatment(P<0.01).Serous retinal detachment(SRD)degradation in group B was significantly better than that in group A at 12mo,and the number of hyperreflective retinal foci(HRFs)in group B was significantly less than that in group A after the treatment.Compared with the two groups,there was no statistical significance in the changes of external retinal membrane(ELM),ellipsoid zone(EZ)and thedisorganization of retinal innerlayers(DRIL)(P>0.05).There was no significant difference in the incidence of subconjunctival hemorrhage and lens opacity between the two groups after treatment,but 10 patients in group B showed increased intraocular pressure(IOP),which was significantly higher than that in group A.Conclusions Both anti-inflammatory and anti-VEGF treatment were effective for RVO-ME,BCVA and SD-OCT biomarkers were improved,anti-inflammatory treatment was superior to anti-VEGF treatment in improving SRD,and there was no difference between anti-inflammatory and anti-VEGF treatment in the number of HRFs.

关 键 词：黄斑水肿 频域相干光层析成像术 生物标志物 抗炎 抗血管内皮生长因子治疗 

分 类 号：R73[医药卫生—肿瘤]