Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Bern Photographic Reading Center, University Hospital Bern, Bern, Switzerland.
Acta Ophthalmol. 2019 Dec;97(8):e1041-e1047. doi: 10.1111/aos.14137. Epub 2019 May 17.
To investigate the prevalence and impact of ganglion cell layer cysts (GCLC) in patients with diabetic macular oedema (DME) under continuous anti-vascular endothelial growth factor (VEGF) therapy.
The clinical findings and spectral domain optical coherence devices of baseline visits and follow-up after 12-24 and 36 months of DME patients under continuous anti-VEGF therapy were retrospectively collected and analysed for the impact of GCLC cysts. Previously established prognostic parameters were also assessed.
A total of 110 eyes of 110 DME patients (mean age 64 ± 10 years) were included. At baseline, 17% eyes had GCLC. With GCLC, the best-corrected visual acuity (BCVA) improvement was in mean 8.4 ± 2.4 Early-Treatment-Diabetic-Retinopathy-Study (ETDRS) letters less over the course of 36 months compared to the group lacking GCLC (p = 0.0009). Eyes with GCLC showed 68 ± 23.4 μm less central retinal thickness (CRT) decrease than eyes lacking GCLC (p < 0.0001). In the linear mixed effect models including external limiting membrane disruption, disintegration of inner retinal layer and epiretinal membrane, GCLC remained a statistical significant factor for the outcome parameter CRT, but missed statistical significance for BCVA.
Ganglion cell layer cysts (GCLC) seem to impact outcome in DME in patients receiving long-term treatment. This prognostic factor warrants further evaluation in the context of already well-established outcome parameters.
研究在接受抗血管内皮生长因子（VEGF）治疗的糖尿病黄斑水肿（DME）患者中，神经节细胞层囊肿（GCLC）的发生率及其影响。
回顾性收集了连续接受抗 VEGF 治疗的 DME 患者的基线检查、治疗后 12-24 个月和 36 个月的临床发现和频域光学相干断层扫描（OCT）结果，分析 GCLC 囊肿对患者的影响。同时还评估了先前建立的预测参数。
共纳入 110 例 110 只眼 DME 患者（平均年龄 64±10 岁）。基线时，17%的眼存在 GCLC。与无 GCLC 的患者相比，有 GCLC 的患者在 36 个月的治疗过程中最佳矫正视力（BCVA）平均提高了 8.4±2.4 个早期治疗糖尿病性视网膜病变研究（ETDRS）字母（p=0.0009）。有 GCLC 的眼比无 GCLC 的眼中央视网膜厚度（CRT）减少了 68±23.4μm（p<0.0001）。在包括外部限制膜破裂、内视网膜层分离和视网膜前膜的线性混合效应模型中，GCLC 仍然是 CRT 这一结果参数的统计学显著因素，但在 BCVA 这一参数中失去了统计学意义。
在接受长期治疗的 DME 患者中，神经节细胞层囊肿（GCLC）似乎会影响治疗效果。这一预测因素在已有成熟的预后参数的基础上，值得进一步评估。
