使用超广角荧光素血管造影术观察玻璃体内植入地塞米松后糖尿病视网膜病变的缺血指数变化：一项初步研究。
Ischemic index changes in diabetic retinopathy after intravitreal dexamethasone implant using ultra-widefield fluorescein angiography: a pilot study.
作者信息
Querques Lea, Parravano Mariacristina, Sacconi Riccardo, Rabiolo Alessandro, Bandello Francesco, Querques Giuseppe
机构信息
Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Via Olgettina 60, Milan, 20132, Italy.
G. B. Bietti Foundation-IRCCS, Rome, Italy.
出版信息
Acta Diabetol. 2017 Aug;54(8):769-773. doi: 10.1007/s00592-017-1010-1. Epub 2017 Jun 2.
AIMS
To investigate the effect of dexamethasone intravitreal implant on peripheral ischemia in patients affected by diabetic macular edema (DME).
METHODS
Patients with treatment-naïve diabetic retinopathy (DR) undergoing intravitreal dexamethasone implant for DME between October 2015 and March 2017 were enrolled. Patients underwent a comprehensive ocular examination at baseline (<2 weeks before treatment) and 10 ± 2 weeks after dexamethasone implant including best-corrected visual acuity (BCVA), intraocular pressure, optical coherence tomography, ultra-widefield (UWF) retinography and UWF fluorescein angiography (UWFA).
RESULTS
Nine eyes of seven consecutive patients (five males; mean age 66.4 ± 6.7 years) were enrolled. Mean duration of DR was 12.3 ± 8.4 years. Mean interval between UWFA acquisitions was 12.1 ± 2.1 weeks, and the mean interval between intravitreal injection and UWFA acquisition was 11.0 ± 1.6 weeks. Mean pre- and post-injection BCVA was 0.30 ± 0.20 and 0.21 ± 0.14 logMAR (p = 0.06), respectively. Mean pre- and post-injection central macular thickness was 449.8 ± 92.5 and 356.3 ± 52.4 μm (p = 0.03), respectively. Mean pre- and post-injection ischemic index was 24.0 ± 25.0 and 9.8 ± 12.1% (p = 0.0427), respectively.
CONCLUSIONS
Intravitreal dexamethasone implant reduces peripheral retina ischemia in patients with DR.
目的
研究玻璃体内注射地塞米松植入物对糖尿病性黄斑水肿（DME）患者周边缺血的影响。
方法
纳入2015年10月至2017年3月间初治的糖尿病性视网膜病变（DR）患者，这些患者因DME接受玻璃体内地塞米松植入治疗。患者在基线期（治疗前<2周）和地塞米松植入后10±2周接受全面的眼部检查，包括最佳矫正视力（BCVA）、眼压、光学相干断层扫描、超广角（UWF）视网膜造影和UWF荧光素血管造影（UWFA）。
结果
连续7例患者（5例男性；平均年龄66.4±6.7岁）的9只眼被纳入研究。DR的平均病程为12.3±8.4年。UWFA采集的平均间隔时间为12.1±2.1周，玻璃体内注射与UWFA采集的平均间隔时间为11.0±1.6周。注射前和注射后的平均BCVA分别为0.30±0.20和0.21±0.14 logMAR（p=0.06）。注射前和注射后的平均中心黄斑厚度分别为449.8±92.5和356.3±52.4μm（p=0.03）。注射前和注射后的平均缺血指数分别为24.0±25.0和9.8±12.1%（p=0.0427）。
结论
玻璃体内注射地塞米松植入物可减轻DR患者的周边视网膜缺血。
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