Kim Tai K, Shin Hye Y, Kim Su Y, Lee Young C, Lee Mee Y
Department of Ophthalmology and Visual Science, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Gyeonggi-do - Korea.
Eur J Ophthalmol. 2017 Nov 8;27(6):746-750. doi: 10.5301/ejo.5000974.
To evaluate factors associated with response to intravitreal bevacizumab (IVB) and intravitreal triamcinolone acetonide (IVTA) in diabetic macular edema (DME).
Ninety-one eyes of 88 patients diagnosed with DME were enrolled in this retrospective chart review. Group 1 included eyes that showed good response to IVB. Group 2 included eyes that did not respond to IVB but responded to IVTA. Group 3 included eyes that responded to neither. Clinical factors, HbA1c, and optical coherence tomography (OCT) findings including patterns of macular edema were compared among the 3 groups.
A total of 44, 27, and 20 eyes were included in groups 1, 2, and 3, respectively. HbA1c was higher in group 3 than in the other groups. Proportion of full (combination of all patterns) type edema was higher in group 3 than in the other 2 groups. In group 1, the proportion of sponge-like diffuse retinal thickening type was higher and cystoid macular edema type was lower than in the other groups.
The degree of diabetic control and morphologic subtypes with OCT should be considered to better predict the prognosis after treatment in DME.
评估糖尿病性黄斑水肿（DME）患者玻璃体内注射贝伐单抗（IVB）和玻璃体内注射曲安奈德（IVTA）治疗反应的相关因素。
本回顾性病历研究纳入了88例诊断为DME患者的91只眼。第1组包括对IVB治疗反应良好的眼。第2组包括对IVB无反应但对IVTA有反应的眼。第3组包括对两者均无反应的眼。比较3组之间的临床因素、糖化血红蛋白（HbA1c）以及光学相干断层扫描（OCT）结果，包括黄斑水肿的类型。
第1组、第2组和第3组分别纳入了44只、27只和20只眼。第3组的HbA1c高于其他组。第3组完全（所有类型组合）型水肿的比例高于其他2组。在第1组中，海绵状弥漫性视网膜增厚型的比例高于其他组，而黄斑囊样水肿型的比例低于其他组。
应考虑糖尿病的控制程度以及OCT形态学亚型，以更好地预测DME治疗后的预后。
