Cho Young Joo, Lee Dong Hyun, Kim Min
1 Department of Ophthalmology, HanGil Eye Hospital, Incheon, Korea.
2 Institute of Vision Research, Department of Ophthalmology, Severance Eye and ENT Hospital, Yonsei, University College of Medicine, Seoul, Republic of Korea.
J Int Med Res. 2018 Nov;46(11):4455-4464. doi: 10.1177/0300060518798503. Epub 2018 Sep 27.
To evaluate the short-term efficacy of intravitreal bevacizumab (IVB) and posterior sub-tenon triamcinolone injections (PSTI) on the basis of spectral-domain optical coherence tomography (SD-OCT) patterns in diabetic macular edema (DME).
We retrospectively reviewed 73 eyes of 73 patients with DME. Based on the presence of serous retinal detachment (SRD), eyes were categorized into two groups, and either IVB or PSTI treatment was performed. Central macular thickness (CMT) and the degree of SRD were assessed preoperatively and 1 month postoperatively. The severity of intraretinal edema was approximated based on the distance from the external limiting membrane to the internal limiting membrane.
In eyes with SRD, reduction of SRD was greater with IVB than with PSTI. Moreover, reduction of intraretinal edema was greater with PSTI than with IVB. In eyes without SRD, PSTI achieved greater CMT reduction, compared with IVB.
In DME patients with SRD, IVB achieved greater reduction of SRD, compared with PSTI; however, intraretinal edema responded more favorably to PSTI, regardless of the presence of SRD. Our results suggest that the classification of DME based on OCT findings may be useful to predict responses to IVB or PSTI treatments.
基于频域光学相干断层扫描(SD-OCT)模式评估玻璃体内注射贝伐单抗(IVB)和后Tenon囊下注射曲安奈德(PSTI)治疗糖尿病性黄斑水肿(DME)的短期疗效。
我们回顾性分析了73例DME患者的73只眼。根据浆液性视网膜脱离(SRD)的有无将患眼分为两组,并分别进行IVB或PSTI治疗。术前及术后1个月评估黄斑中心厚度(CMT)和SRD程度。根据从外界膜到内界膜的距离估算视网膜内水肿的严重程度。
在存在SRD的患眼中,IVB组SRD的减轻程度大于PSTI组。此外,PSTI组视网膜内水肿的减轻程度大于IVB组。在不存在SRD的患眼中,与IVB相比,PSTI使CMT降低得更多。
在伴有SRD的DME患者中,与PSTI相比,IVB使SRD减轻得更多;然而,无论是否存在SRD,视网膜内水肿对PSTI的反应更良好。我们的结果表明,基于OCT结果对DME进行分类可能有助于预测对IVB或PSTI治疗的反应。