比较光学相干断层扫描对不同糖尿病性黄斑水肿成分的临床疗效。
Comparison of clinical outcomes of different components of diabetic macular edema on optical coherence tomography.
机构信息
Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences; School of Medicine, South China University of Technology, Guangzhou, China.
Aier School of Ophthalmology, Central South University, Changsha, China.
出版信息
Graefes Arch Clin Exp Ophthalmol. 2019 Dec;257(12):2613-2621. doi: 10.1007/s00417-019-04471-3. Epub 2019 Sep 16.
PURPOSE
To evaluate the edema reduction after intravitreal injection of ranibizumab (IVR) in two diabetic macular edema (DME) components in the same eye using optical coherence tomography (OCT).
METHODS
Totally 113 eyes with mixed OCT pattern of DME were included. All the eyes underwent best-corrected visual acuity (BCVA) examination and OCT scanning at baseline and follow-up visits (1, 3, and 6 months after 3 monthly consecutive IVR). The mixed OCT pattern of DME was classified into 2 OCT components: serous retinal detachment (SRD) component and non-SRD component. Foveal thickness of the SRD component (SRDFT) and the non-SRD component (NSRDFT) was compared between baseline and follow-up visits. Reduction and reduction ratio of the SRDFT and the NSRDFT at each follow-up were compared. When calculating the NSRDFT reduction ratio, we innovatively optimized a commonly used formula by subtracting the normal foveal thickness from the baseline NSRDFT.
RESULTS
SRDFT was 265.6 ± 175.4 μm at baseline and was significantly decreased to 126.7 ± 114.4 μm at 1 month, to 110.5 ± 103.4 μm at 3 months, and to 110.4 ± 89.6 μm at 6 months (all P < 0.001). NSRDFT was 409.5 ± 173.1 μm at baseline and was significantly decreased to 274.1 ± 140.4 μm at 1 month, to 249.1 ± 95.9 μm at 3 months, and to 254.1 ± 90.4 μm at 6 months (all P < 0.001). There was no significant difference in reduction or reduction ratio between NSRDFT and SRDFT during follow-up (all P > 0.05). The correlation between BCVA and SRDFT was most significant at baseline (r = 0.366, P < 0.001) and the correlation between BCVA and NSRDFT was most significant at 6 months (r = 0.426, P < 0.001). BCVA improvement was more significantly correlated with reduction or reduction ratio of SRDFT at each follow-up timepoint (r = 0.271-0.426, all P < 0.01).
CONCLUSIONS
IVR was effective in reducing both the SRD and non-SRD components of DME according to our optimized formula. The association between BCVA improvement and edema reduction was more significant in the SRD component.
目的
使用光学相干断层扫描（OCT）评估同一眼中两种糖尿病性黄斑水肿（DME）成分的玻璃体内注射雷珠单抗（IVR）后的水肿减轻情况。
方法
共纳入 113 只眼患有混合 OCT 模式的 DME。所有眼均在基线和随访（连续 3 个月的 IVR 后 1、3 和 6 个月）时接受最佳矫正视力（BCVA）检查和 OCT 扫描。DME 的混合 OCT 模式分为 2 个 OCT 成分：浆液性视网膜脱离（SRD）成分和非-SRD 成分。比较基线和随访时 SRD 成分（SRDFT）和非-SRD 成分（NSRDFT）的视网膜厚度。比较每个随访时 SRDFT 和 NSRDFT 的减少量和减少率。在计算 NSRDFT 减少率时，我们创新性地通过从基线 NSRDFT 中减去正常黄斑中心凹厚度，优化了一个常用公式。
结果
基线时 SRDFT 为 265.6±175.4μm，1 个月时显著降低至 126.7±114.4μm，3 个月时降低至 110.5±103.4μm，6 个月时降低至 110.4±89.6μm（均 P<0.001）。基线时 NSRDFT 为 409.5±173.1μm，1 个月时显著降低至 274.1±140.4μm，3 个月时降低至 249.1±95.9μm，6 个月时降低至 254.1±90.4μm（均 P<0.001）。在随访期间，NSRDFT 和 SRDFT 的减少或减少率之间无显著差异（均 P>0.05）。BCVA 与 SRDFT 的相关性在基线时最为显著（r=0.366，P<0.001），而 BCVA 与 NSRDFT 的相关性在 6 个月时最为显著（r=0.426，P<0.001）。BCVA 的改善与每个随访时间点 SRDFT 的减少或减少率的相关性更为显著（r=0.271-0.426，均 P<0.01）。
结论
根据我们优化的公式，IVR 对 DME 的 SRD 和非-SRD 成分均有效。在 SRD 成分中，BCVA 改善与水肿减轻之间的相关性更为显著。
Zotero 插件