Xu Yupeng, Qu Yuan, Suo Yan, Gao Jian, Chen Xia, Liu Kun, Xu Xun
Department of Ophthalmology, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Engineering Center for Visual Science and Photo Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Ophthalmology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
BMC Ophthalmol. 2019 May 31;19(1):123. doi: 10.1186/s12886-019-1131-0.
To assess the changes in individual retinal layer thickness and visual function associated with gains in visual acuity after an intravitreal conbercept injection in the diabetic macular edema (DME) on spectral domain optical coherence tomography (SD-OCT) and microperimetry during 1-year follow-up.
Retrospective observational study. Twenty patients with clinically significant DME in the study eye were imaged by SD-OCT every 3 months and MP1 microperimeter in the third month while receiving anti-vascular endothelial growth factor (VEGF) (conbercept) treatment. In each patient, seven retinal layers were segmented in 98 scans covering a 6 mm × 6 mm area of the macula at baseline and during 1 year of treatment. An automatic, full-threshold microperimetry of the central field (10° × 10°, 40 stimulated points) with the MP1 microperimeter. Thickness and microperimetry changes were quantitatively measured and evaluated for their correlation with increases in visual acuity.
Although thicknesses of the inner nuclear layer (INL) and the outer nuclear layer (ONL) were reduced the most after treatment (p < 0.05), decreases of the ganglion cell layer (GCL) (r = 0.591, p = 0.006) and inner plexiform layer (IPL) (r = 0.663, p = 0.001) in central subfield area was associated with best-corrected visual acuity (BCVA) gain, and had the best estimation of BCVA gain (adjust R = 0.544). Mean macular sensitivity in the central subfield was also well correlated with BCVA gain (r = 0.531, p = 0.016).
Neural recovery occurred after the resolution of edema during conbercept treatment, due to the decreases in GCL and IPL associating with gains in vision and improved microperimetry.
评估糖尿病性黄斑水肿（DME）患者玻璃体内注射康柏西普后1年随访期间，基于频域光学相干断层扫描（SD - OCT）和微视野计测量的视网膜各层厚度及视觉功能变化与视力提高之间的关系。
回顾性观察研究。20例患眼有临床显著性DME的患者在接受抗血管内皮生长因子（VEGF）（康柏西普）治疗期间，每3个月进行一次SD - OCT检查，并在第3个月进行MP1微视野计检查。对每位患者在基线及治疗1年期间，于黄斑区6mm×6mm区域进行98次扫描，分割出7个视网膜层。使用MP1微视野计对中心视野（10°×10°，40个刺激点）进行自动全阈值微视野检查。定量测量厚度和微视野计变化，并评估其与视力提高的相关性。
尽管治疗后内核层（INL）和外核层（ONL）厚度减少最为明显（p < 0.05），但中心子区域神经节细胞层（GCL）厚度减少（r = 0.591，p = 0.006）和内丛状层（IPL）厚度减少（r = 0.663，p = 0.001）与最佳矫正视力（BCVA）提高相关，且对BCVA提高的估计最佳（调整R = 0.544）。中心子区域的平均黄斑敏感度也与BCVA提高密切相关（r = 0.531，p = 0.016）。
康柏西普治疗期间水肿消退后发生了神经恢复，这是由于GCL和IPL厚度减少与视力提高及微视野计改善相关。
