Department of Ophthalmology, Medical University of Vienna , Vienna, Austria.
Center for Medical Statistics, Informatics and Intelligent Systems, Section for Medical Statistics, Medical University of Vienna , Vienna, Austria.
Curr Eye Res. 2020 Sep;45(9):1107-1113. doi: 10.1080/02713683.2020.1712728. Epub 2020 Feb 4.
The aim of this study was to evaluate and compare microperimetry changes in patients with clinically significant diabetic macular edema secondary to diabetes mellitus, following intravitreal injections of bevacizumab or triamcinolone during a follow-up of 1 year after treatment.
30 patients with clinically significant macular edema were randomized into two groups of 15 patients each. One group initially received three intravitreal injections of 2.5 mg bevacizumab at monthly intervals. The other received a single injection of 8 mg of triamcinolone followed by two sham interventions at monthly intervals. Best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were measured. Macular function was documented by microperimetry at baseline, 3, 6, 9 months and at the last visit of each patient.
In the bevacizumab group, the mean differential light threshold (±standard deviation) under therapy improved significantly from 8.40 (± 3.8) dB to 12.8 (±4.3) dB at the 12-month follow-up visit (p ≤ .05), whereas in the triamcinolone group it increased from 8.0 (± 2.4) dB at baseline to 9.3 (±3.6) dB at the last visit without reaching statistical significance ( > .05). The mean differential light thresholds between the two groups were not statistically significant at baseline or the last visit ( > .05). In the bevacizumab group, the improvement (slope) in mean differential light threshold was significantly superior to the Triamcinolone group (Estimate = 0.588, p ≤ .05).
Central macular function as measured by microperimetry in patients with acute DME improved in addition to anatomical restoration after intravitreal bevacizumab and triamcinolone injection. In our clinical study, the measures of the variables in patients receiving bevacizumab were superior to those receiving triamcinolone throughout the one-year observation period.
本研究旨在评估和比较糖尿病性黄斑水肿患者接受贝伐单抗或曲安奈德玻璃体腔内注射治疗 1 年后的微视野变化。
将 30 例临床显著黄斑水肿患者随机分为两组，每组 15 例。一组患者最初每月接受 2.5mg 贝伐单抗玻璃体腔内注射 3 次。另一组患者接受 8mg 曲安奈德单次注射，随后每月进行 2 次假手术。测量最佳矫正视力（BCVA）和中心视网膜厚度（CRT）。在基线、3、6、9 个月和每位患者的最后一次就诊时，通过微视野记录黄斑功能。
在贝伐单抗组，治疗期间平均光阈值差异（±标准差）从治疗前的 8.40（±3.8）dB 显著改善至 12 个月随访时的 12.8（±4.3）dB（p≤0.05），而曲安奈德组从基线的 8.0（±2.4）dB 增加至最后一次就诊时的 9.3（±3.6）dB，但无统计学意义（>0.05）。两组间平均光阈值差异在基线或最后一次就诊时无统计学意义（>0.05）。贝伐单抗组平均光阈值差异的改善（斜率）明显优于曲安奈德组（估计值=0.588，p≤0.05）。
除了解剖结构恢复外，急性 DME 患者接受玻璃体内贝伐单抗和曲安奈德注射后，中央黄斑功能也通过微视野得到改善。在我们的临床研究中，接受贝伐单抗治疗的患者的各项指标在整个 1 年观察期内均优于接受曲安奈德治疗的患者。
