Preti Rony C, Mutti Anibal, Ferraz Daniel A, Zacharias Leandro C, Nakashima Yoshitaka, Takahashi Walter Y, Monteiro Mario L R
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Oftalmologia, São Paulo/SP, Brazil.
Clinics (Sao Paulo). 2017 Feb 1;72(2):81-86. doi: 10.6061/clinics/2017(02)03.
: To investigate the effect of laser pan-retinal photocoagulation with or without intravitreal bevacizumab injections on macular choroidal thickness parameters in eyes with high-risk proliferative diabetic retinopathy.
: High-risk proliferative diabetic retinopathy patients undergoing laser treatment were prospectively enrolled in this study. One eye was randomly selected for laser treatment combined with bevacizumab injections, study group, whereas the corresponding eye was subjected to laser treatment alone, control group. Spectral-domain optical coherence tomography with enhanced depth imaging was used to measure the macular choroidal thickness prior to and 1 month after treatment. Measurements in both groups were compared. Clinicaltrials.gov: NCT01389505.
: Nineteen patients (38 eyes) with a mean±standard deviation age of 53.4±9.3 years were evaluated, and choroidal thickness measurements for 15 patients were used for comparison. The greatest measurement before treatment was the subfoveal choroidal thickness (341.68±67.66 μm and 345.79±83.66 μm for the study and control groups, respectively). No significant difference between groups was found in terms of macular choroidal thickness measurements at baseline or after treatment. However, within-group comparisons revealed a significant increase in choroidal thickness parameters in 10 measurements in the study group and in only 5 temporal measurements in the control group when 1-month follow-up measurements were compared to baseline values.
: The macular choroidal thickness does not appear to be significantly influenced by laser treatment alone but increases significantly when associated with bevacizumab injections in patients with proliferative diabetic retinopathy and macular edema. Because bevacizumab injections reduce short-term laser pan-retinal photocoagulation-induced macular edema, our findings suggest that the choroid participates in its pathogenesis.
研究激光全视网膜光凝联合或不联合玻璃体内注射贝伐单抗对高危增殖性糖尿病视网膜病变患者黄斑脉络膜厚度参数的影响。
前瞻性纳入接受激光治疗的高危增殖性糖尿病视网膜病变患者。随机选择一只眼进行激光治疗联合贝伐单抗注射,为研究组,而对侧眼仅接受激光治疗,为对照组。使用具有增强深度成像的光谱域光学相干断层扫描术在治疗前和治疗后1个月测量黄斑脉络膜厚度。比较两组的测量结果。Clinicaltrials.gov:NCT01389505。
评估了19例患者(38只眼),平均年龄±标准差为53.4±9.3岁,15例患者脉络膜厚度测量结果用于比较。治疗前最大测量值为中心凹下脉络膜厚度(研究组和对照组分别为341.68±67.66μm和345.79±83.66μm)。两组在基线或治疗后的黄斑脉络膜厚度测量方面未发现显著差异。然而,组内比较显示,将1个月随访测量值与基线值相比时,研究组10次测量中脉络膜厚度参数显著增加,而对照组仅5次颞侧测量中显著增加。
单独激光治疗似乎对黄斑脉络膜厚度没有显著影响,但在增殖性糖尿病视网膜病变和黄斑水肿患者中,与贝伐单抗注射联合时脉络膜厚度显著增加。由于贝伐单抗注射可减轻短期激光全视网膜光凝引起的黄斑水肿,我们的研究结果表明脉络膜参与了其发病机制。