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OACSTPCD
Observation of SD-OCT biomarkers after anti-inflammatory and anti-VEGF treatment for macular edema secondary to retinal vein occlusion
目的 评估视网膜静脉阻塞继发黄斑水肿(RVO-ME)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(SD-OCT)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RVO-ME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)、SD-OCT的生物标志物和不良反应,比较两组在治疗前后BCVA、SD-OCT的变化和不良反应的发生率.结果 两组患者治疗后BCVA、SD-OCT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RVO-ME均有效,BCVA和SD-OCT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 tomogra-phy(SD-OCT)biomarkers in patients with retinal vein obstruction secondary macular edema(RVO-ME)after anti-inflammatory 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 Affili-ated 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.Bio-markers of best corrected visual acuity(BCVA)and SD-OCT and adverse reactions were recorded at baseline and 12mo af-ter 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.
毕双双;戴馨;崔京卫;平继花;辛贺贺
274000 菏泽,菏泽医学专科学校274000 菏泽,菏泽医学专科学校274000 菏泽,菏泽医学专科学校附属医院眼科274000 菏泽,菏泽医学专科学校274000 菏泽,菏泽医学专科学校
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
Macular edemaSpectral domain optical coherence tomographyBiomarkersAnti-inflammatory therapyAnti-vascular endothelial growth factor therapy
《临床眼科杂志》 2024 (6)
495-499,5
2021年山东省医药卫生科技发展计划项目(202107021084)
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