糖尿病性黄斑水肿抗VEGF治疗前后视网膜内液体积量化与视觉功能相关性  

Quantification of intraretinal fluid volume and its correlation with visual function before and after anti-VEGF treatment in diabetic macular edema

作　　者：刘逸 沈亚丹 郭楚云 陈丽 李杰 倪光明 钟捷 LIU Yi;SHEN Yadan;GUO Chuyun;CHEN Li;LI Jie;NI Guangming;ZHONG Jie(Department of Ophthalmology,Affiliated Hospital of University of Electronic Science and Technology of China,Sichuan Provincial People’s Hospital,Chengdu 610072,Sichuan Province,China;Eye School of Chengdu University of Traditional Chinese Medicine,Chengdu 610032,Sichuan Province,China;School of Optoelectronic Science and Engineering,University of Electronic Science and Technology of China,Chengdu 611731,Sichuan Province,China)

机构地区：[1]电子科技大学附属医院·四川省人民医院眼科,四川省成都市610072 [2]成都中医药大学眼科学院,四川省成都市610032 [3]电子科技大学光电科学与工程学院,四川省成都市611731

出　　处：《眼科新进展》2025年第5期369-374,共6页Recent Advances in Ophthalmology

基　　金：国家自然科学基金项目(编号:62376173,61905036);四川省卫健委重点研发项目(编号:ZH2024-201);北京医卫健康公益基金会医学科学研究项目(编号:YWJKJHKYJJ-KHE2405)。

摘　　要：目的基于深度学习的三维网络分割模型量化糖尿病性黄斑水肿(DME)患者的视网膜内液(IRF)体积,探讨IRF体积与视功能和OCT视网膜参数的关系。方法前瞻性纳入2022年7月到2024年9月于四川省人民医院眼科就诊的DME患者37例(42眼)。使用三维分割模型自动量化基线和末次随访时6 mm×6 mm OCT范围内的IRF体积。分析基线和末次随访时,视力与IRF体积、中央视网膜厚度(CST)、视网膜内层紊乱(DRIL)、高反射物质(HRF)、外界膜(ELM)、椭圆体带(EZ)、玻璃体黄斑界面异常(VMIA)的相关性;分析基线和末次随访时,IRF体积与CST、DRIL、HRF、ELM、EZ、VMIA的相关性以及末次随访时视力与基线时IRF体积、CST、DRIL、HRF、ELM、EZ、VMIA的相关性。结果与基线相比,末次随访时患者BCVA(logMAR)显著上升,IRF体积与CST显著下降,HRF显著减少,DRIL、ELM、EZ显著恢复(均为P<0.05),VMIA无显著变化(P=1.000)。基线时,BCVA与IRF体积、CST、DRIL、HRF均呈负相关,与ELM、EZ均呈正相关(均为P<0.05);与VMIA无相关性(P=0.069)。末次随访时,BCVA与DRIL、HRF、VMIA均呈负相关,与ELM、EZ均呈正相关(均为P<0.01);与IRF体积、CST均无相关性(P=0.419、0.994)。基线时,IRF体积与CST呈正相关(P<0.001);与ELM、EZ均呈负相关(均为P<0.01);与DRIL、HRF、VMIA均无相关性(均为P>0.05)。末次随访时,IRF体积与CST、HRF均呈正相关(均为P<0.01);与DRIL、ELM、EZ、VMIA均无相关性(均为P>0.05)。末次随访时BCVA与基线时BCVA、ELM、EZ均呈正相关,与基线时的IRF体积、CST、DRIL、HRF、VMIA均呈负相关(均为P<0.05)。结论DME患者基线IRF体积是基线和末次随访时视力的重要影响因素,IRF体积是DME管理中的潜在生物标志物。Objective To quantify the intraretinal fluid(IRF)volume in patients with diabetic macular edema(DME)using a deep learning-based three-dimensional segmentation model and to investigate the relationship of IRF volume with visual function and retinal biomarkers based on optical coherence tomography(OCT).Methods A total of 37 patients(42 eyes)with DME who received treatment in the Ophthalmology Department of Sichuan Provincial People's Hospital from July 2022 to September 2024 were prospectively included in this study.A three-dimensional segmentation model was used to automatically quantify the IRF volume within a 6 mm×6 mm OCT scan at baseline and at the last follow-up.The correlation of visual acuity with IRF volume,central subfield thickness(CST),disorganization of the retinal inner layers(DRIL),hyperreflective foci(HRF),external limiting membrane(ELM),ellipsoid zone(EZ),and vitreomacular interface abnormality(VMIA)was analyzed at baseline and the last follow-up.Additionally,the correlation of IRF volume with CST,DRIL,HRF,ELM,EZ,and VMIA was analyzed at both time points.Furthermore,the correlation of the visual acuity at the last follow-up with the IRF volume,CST,DRIL,HRF,ELM,EZ,and VMIA at baseline was analyzed.Results Compared with the baseline value,patients exhibited a significant increase in the best corrected visual acuity(BCVA)(logMAR),a significant decrease in the IRF volume and CST,a significant reduction in the HRF,a significant recovery in the DRIL,ELM,and EZ(all P<0.05),and no significant changes in the VMIA(P=1.000)at the last follow-up.At baseline,the BCVA was negatively correlated with the IRF volume,CST,DRIL,and HRF,but positively correlated with the ELM and EZ(all P<0.05);there was no correlation between the BCVA and VMIA(P=0.069).At the last follow-up,the BCVA was negatively correlated with the DRIL,HRF,and VMIA,but positively correlated with the ELM and EZ(all P<0.01);the BCVA did not correlate with the IRF volume and CST(P=0.419 and 0.994).At baseline,the IRF volume was positively correlated w

关 键 词：糖尿病性黄斑水肿 三维分割 IRF体积 OCT生物标志物 最佳矫正视力 

分 类 号：R774.1[医药卫生—眼科]