玻璃体内注射阿柏西普对糖尿病性黄斑水肿患者眼内微血管消退的多重作用

Multiple Effects of Intravitreal Aflibercept on Microvascular Regression in Eyes with Diabetic Macular Edema.

作者信息

Sugimoto Masahiko, Ichio Atushi, Mochida Daiki, Tenma Yumiho, Miyata Ryohei, Matsubara Hisashi, Kondo Mineo

机构信息

Department of Ophthalmology, Mie University Graduate School of Medicine, Tsu, Japan.

出版信息

Ophthalmol Retina. 2019 Dec;3(12):1067-1075. doi: 10.1016/j.oret.2019.06.005. Epub 2019 Jun 15.

DOI:10.1016/j.oret.2019.06.005

PMID:31446029

Abstract

PURPOSE

To evaluate the effects of intravitreal aflibercept (IVA) on the number of microaneurysms and sizes of nonperfused areas (NPAs) in eyes with diabetic macular edema (DME).

DESIGN

Interventional, prospective study.

PARTICIPANTS

Twenty-five eyes of 25 DME patients (average age, 64.0±8.8 years) were treated with 3 consecutive monthly IVA injections.

METHODS

Fluorescein angiography (FA) and OCT were performed before the IVA injections (baseline) and at 1 week after the IVA treatment. The number of microaneurysms and the ischemic index (ISI), a measure of NPA, were determined. The correlations between central retinal thickness (CRT) and number of microaneurysms and the ISI were also determined.

MAIN OUTCOME MEASURES

The mean number of microaneurysms and NPA evaluated as the ISI.

RESULTS

At baseline, the mean CRT was 485.7±90.6 μm. After treatment, the mean CRT was reduced significantly to 376.9±81.6 μm (P = 0.1 × 10, repeated analysis of variance). The mean number of microaneurysms was decreased significantly from 49.6±33.2 at baseline to 24.8±18.1 at 3 months after the initial treatment. This was a 50.4±21.2% reduction (P = 0.3 × 10, paired t test). The mean ISI was also decreased significantly from 55.5±20.4% at baseline to 28.8±16.8% after treatment (P = 0.3 × 10, paired t test). This was a reduction of 43.3±28.5%. A significant correlation was found between the CRT and number of microaneurysms at both baseline (r = 0.56; P = 0.004) and after treatment (r = 0.53; P = 0.006). A significant correlation was found between CRT and ISI at baseline (r = -0.39; P = 0.03) but not after treatment (r = -0.06; P = 0.79).

CONCLUSIONS

The reduction in the number of microaneurysms was correlated with reduction in CRT.

摘要

目的

评估玻璃体内注射阿柏西普（IVA）对糖尿病性黄斑水肿（DME）患者眼内微动脉瘤数量及无灌注区（NPA）大小的影响。

设计

干预性前瞻性研究。

参与者

25例DME患者的25只眼（平均年龄64.0±8.8岁）接受连续3个月每月1次的IVA注射治疗。

方法

在IVA注射前（基线）及IVA治疗后1周进行荧光素血管造影（FA）和光学相干断层扫描（OCT）。测定微动脉瘤数量及作为NPA指标的缺血指数（ISI）。还测定了中心视网膜厚度（CRT）与微动脉瘤数量及ISI之间的相关性。

主要观察指标

评估微动脉瘤的平均数量及作为ISI的NPA。

结果

基线时，平均CRT为485.7±90.6μm。治疗后，平均CRT显著降至376.9±81.6μm（P = 0.1×10，重复方差分析）。微动脉瘤的平均数量从基线时的49.6±33.2显著降至初始治疗后3个月时的24.8±18.1。降低了50.4±21.2%（P = 0.3×10，配对t检验）。平均ISI也从基线时的55.5±20.4%显著降至治疗后的28.8±16.8%（P = 0.3×10，配对t检验）。降低了43.3±28.5%。在基线时（r = 0.56；P = 0.004）及治疗后（r = 0.53；P = 0.006），CRT与微动脉瘤数量之间均存在显著相关性。在基线时CRT与ISI之间存在显著相关性（r = -0.39；P = 0.03），但治疗后无相关性（r = -0.06；P = 0.79）。