在中国，光学相干断层扫描（OCT）图像中的高反射灶作为糖尿病性黄斑水肿患者接受康柏西普治疗预后不良的生物标志物。
Hyperreflective foci in OCT image as a biomarker of poor prognosis in diabetic macular edema patients treating with Conbercept in China.
作者信息
Liu Shulin, Wang Desai, Chen Fei, Zhang Xuedong
机构信息
The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology and Chongqing Eye Institute, 1 You Yi Road, Yu Zhong District, Chongqing, 400016, People's Republic of China.
Ophthalmology Department, The people's Hospital of BiShan District of Chongqing City, Chongqing, People's Republic of China.
出版信息
BMC Ophthalmol. 2019 Jul 23;19(1):157. doi: 10.1186/s12886-019-1168-0.
PURPOSE
To investigate the dynamic changes of hyperreflective foci (HF) in diabetic macular edema (DME) patients during the intravitreal Conbercept treatment in China.
METHODS
DME Patients receiving intravitreal Conbercept (IVC) injections during the year 2016-2017 were retrospectively investigated. Thirteen patients (26 eyes) were recruited in this study. They received IVC once a month for 3 consecutive months. The number and location of HFs, the best-corrected visual acuity (BCVA) and central macular thickness (CMT) at each visit were analyzed and compared.
RESULTS
After the first injection, BCVA (LogMAR) was increased from 0.75 ± 0.48 to 0.43 ± 0.24 (p < 0.05), CMT improved from 575.9 ± 191.9 to 388.2 ± 198.5 μm (p = 0.014). However, the BCVA and CMT had no statistical difference after the second and third injection as compared with those after the first injection respectively. The baseline number of HFs was 5.39 ± 4.24, 5.15 ± 5.17 and 0.88 ± 1.90 in the inner retinal, outer retinal and subretinal layer respectively. The number of HFs in these three retinal layers decreased significantly after the first injection (p = 0.0045, p < 0.0001 and p = 0.0045, respectively). However, after the second injection, only the number of HFs in the inner retinal layer experienced a further decrease. After the third injection, no statistically significant HFs changes was observed in each retinal layers. Correlation analysis showed that there was a positive significant correlation between the baseline number of HFs in the inner retina, outer retina, subretina and final BCVA (r = 0.571, p = 0.002; r = 0.464, p = 0.017; r = 0.405, p = 0.04 respectively). There was also a significant positive correlation between outer retinal HFs reduction, total retinal HFs reduction and increase of BCVA (r = 0.40, p = 0.043 and r = 0.393, p = 0.04 respectively). There were no severe ocular adverse reactions or systemic adverse events.
CONCLUSIONS
Conbercept is effective and safe in the treatment of DME. HFs can act as a biomarker of poor final visual outcome.
目的
研究中国糖尿病性黄斑水肿（DME）患者玻璃体内注射康柏西普治疗期间高反射灶（HF）的动态变化。
方法
回顾性研究2016年至2017年期间接受玻璃体内注射康柏西普（IVC）的DME患者。本研究招募了13例患者（26只眼）。他们连续3个月每月接受一次IVC注射。分析并比较每次就诊时HF的数量和位置、最佳矫正视力（BCVA）和中心黄斑厚度（CMT）。
结果
首次注射后，BCVA（LogMAR）从0.75±0.48提高到0.43±0.24（p<0.05），CMT从575.9±191.9改善至388.2±198.5μm（p = 0.014）。然而，第二次和第三次注射后的BCVA和CMT与首次注射后相比分别无统计学差异。HF的基线数量在内视网膜、外视网膜和视网膜下分别为5.39±4.24、5.15±5.17和0.88±1.90。首次注射后这三个视网膜层的HF数量均显著减少（分别为p = 0.0045、p<0.0001和p = 0.0045）。然而，第二次注射后，仅内视网膜层的HF数量进一步减少。第三次注射后，各视网膜层未观察到HF有统计学意义的变化。相关性分析显示，内视网膜、外视网膜、视网膜下HF的基线数量与最终BCVA之间存在显著正相关（r = 0.571，p = 0.002；r = 0.464，p = 0.017；r = 0.405，p = 0.04）。外视网膜HF减少、总视网膜HF减少与BCVA增加之间也存在显著正相关（r = 0.40，p = 0.043和r = 0.393，p = 0.04）。未出现严重眼部不良反应或全身不良事件。
结论
康柏西普治疗DME有效且安全。HF可作为最终视力不佳的生物标志物。
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