Kniggendorf Vinicius F, Novais Eduardo A, Kniggendorf Sergio L, Xavier Camilla, Cole Emily D, Regatieri Caio V
Hospital Oftalmológico de Brasília, Brasília, DF, Brazil.
Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
Arq Bras Oftalmol. 2016 May-Jun;79(3):155-8. doi: 10.5935/0004-2749.20160047.
To evaluate choroidal thickness (CT) using spectral domain optical coherence tomography (SD-OCT) imaging at baseline and 6 months after intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment in patients with diabetic macular edema (DME).
A retrospective chart review was performed to identify patients with DME who underwent intravitreal injection of anti-VEGF (bevacizumab or ranibizumab) in a pro re nata (PRN) regimen. Subfoveal choroidal thickness was compared between values obtained at baseline and at 6-month follow-up visits.
Thirty-nine eyes (15 females, 24 males) from 39 patients were enrolled (mean age, 62.43 ± 8.7 years; range, 44-79 years). Twenty-three and 16 eyes were treated with ranibizumab and bevacizumab respectively. The mean number of anti-VEGF injections was 2.28 ± 1.27 (range, 1-5). Mean nasal, subfoveal, and temporal choroidal thickness (CT) measurements at baseline were 234.10 ± 8.63 µm, 246.89 ± 8.94 µm, and 238.12 ± 8.20 µm, respectively, and those at 6 months post-treatment were 210.46 ± 8.00 µm, 215.66 ± 8.29 µm, and 212.43 ± 8.14 µm, respectively. Significant differences in CT were observed between baseline and the 6-month follow-up at all measured points (p=0.0327).
Over a 6-month period, the use of intravitreal anti-VEGF was associated with significant thinning of the choroid in patients with DME. The clinical significance of a thinner choroid in DME is currently unknown; however, it may contribute to long-term adverse effects on choroidal and retinal function, representing an area requiring future investigation.
利用光谱域光学相干断层扫描(SD - OCT)成像技术评估糖尿病性黄斑水肿(DME)患者在玻璃体内注射抗血管内皮生长因子(抗VEGF)治疗前及治疗6个月后的脉络膜厚度(CT)。
进行一项回顾性病历审查,以确定采用按需(PRN)方案接受玻璃体内注射抗VEGF(贝伐单抗或雷珠单抗)治疗的DME患者。比较基线时和6个月随访时获得的黄斑中心凹下脉络膜厚度值。
纳入了39例患者的39只眼(15例女性,24例男性)(平均年龄62.43±8.7岁;范围44 - 79岁)。分别有23只眼和16只眼接受了雷珠单抗和贝伐单抗治疗。抗VEGF注射的平均次数为2.28±1.27(范围1 - 5次)。基线时鼻侧、黄斑中心凹下和颞侧脉络膜厚度(CT)的平均测量值分别为234.10±8.63μm、246.89±8.94μm和238.12±8.20μm,治疗后6个月时分别为210.46±8.00μm、215.66±8.29μm和212.43±8.14μm。在所有测量点,基线和6个月随访时的CT均存在显著差异(p = 0.0327)。
在6个月期间,玻璃体内注射抗VEGF与DME患者脉络膜显著变薄有关。脉络膜变薄在DME中的临床意义目前尚不清楚;然而,它可能会对脉络膜和视网膜功能产生长期不良影响,这是一个需要未来研究的领域。