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玻璃体内注射抗血管内皮生长因子治疗糖尿病视网膜病变后的视网膜再灌注

Retinal reperfusion in diabetic retinopathy following treatment with anti-VEGF intravitreal injections.

作者信息

Levin Ariana M, Rusu Irene, Orlin Anton, Gupta Mrinali P, Coombs Peter, D'Amico Donald J, Kiss Szilárd

机构信息

Department of Ophthalmology, Weill Cornell Medical College, New York, NY, USA.

出版信息

Clin Ophthalmol. 2017 Jan 21;11:193-200. doi: 10.2147/OPTH.S118807. eCollection 2017.

Abstract

PURPOSE

The aim of this study is to report peripheral reperfusion of ischemic areas of the retina on ultra-widefield fluorescein angiography (UWFA) following anti-vascular endothelial growth factor (VEGF) intravitreal injections in patients treated for diabetic retinopathy.

METHODS

This study is a retrospective review of 16 eyes of 15 patients with diabetic retinopathy, who received anti-VEGF intravitreal injections and underwent pre- and postinjection UWFA. The main outcome measured was the presence of reperfusion in postinjection UWFA images in areas of the retina that demonstrated nonperfusion in preinjection images. Images were analyzed for reperfusion qualitatively and quantitatively by two graders.

RESULTS

Twelve of 16 eyes (75%) or 11 of 15 patients (73.3%) demonstrated reperfusion following anti-VEGF injection. On UWFA, reperfusion was detected both within the field of 7-standard field (7SF) fluorescein angiography and in the periphery outside the 7SF. Four of 16 eyes or 4 of 15 patients did not demonstrate reperfusion, one of which had extensive scarring from prior panretinal photocoagulation.

CONCLUSION

In patients with diabetic retinopathy, treatment with anti-VEGF agents can be associated with reperfusion of areas of nonperfusion, as demonstrated by UWFA.

摘要

目的

本研究旨在报告糖尿病视网膜病变患者接受抗血管内皮生长因子(VEGF)玻璃体内注射后,超广角荧光素血管造影(UWFA)显示的视网膜缺血区域的周边再灌注情况。

方法

本研究对15例糖尿病视网膜病变患者的16只眼进行回顾性分析,这些患者接受了抗VEGF玻璃体内注射,并在注射前后进行了UWFA检查。主要观察指标是注射后UWFA图像中,在注射前图像显示无灌注的视网膜区域是否存在再灌注。由两名评分者对图像进行定性和定量的再灌注分析。

结果

16只眼中的12只(75%)或15例患者中的11例(73.3%)在抗VEGF注射后显示出再灌注。在UWFA上,在7标准视野(7SF)荧光素血管造影视野内和7SF以外的周边区域均检测到再灌注。16只眼中的4只或15例患者中的4例未显示再灌注,其中1例因先前的全视网膜光凝有广泛瘢痕形成。

结论

如UWFA所示,糖尿病视网膜病变患者使用抗VEGF药物治疗可伴有无灌注区域的再灌注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70df/5268366/e1553dd08430/opth-11-193Fig1.jpg

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