Department of Ophthalmology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Kaiya Eye Clinic, Hamamatsu, Japan.
Jpn J Ophthalmol. 2020 May;64(3):250-256. doi: 10.1007/s10384-019-00698-z. Epub 2020 Feb 27.
To evaluate aqueous flare change patterns following anti-vascular endothelial growth factor therapy for diabetic macular edema (DME) and investigate the relationship between changes in flare values and central macular thickness (CMT).
Retrospective, interventional case series METHODS: A total of 84 eyes of 62 patients with DME received either intravitreal ranibizumab (IVR; n = 62) or aflibercept (IVA; n = 22). A laser flare photometer (Kowa FM500, Kowa Company, Ltd) was used to measure flare values, and CMT was assessed using optical coherence tomography. Flare values and CMT were measured prior to injection (baseline) and at, 1, 7 and 14 days after injection.
Flare values in the IVR group decreased significantly at day 14 (P = 0.001), whereas the IVA group showed a significant increase in flare values at day 1 (P < 0.001). In the IVA group, the baseline flare values were significantly higher in the CMT reduction group than in the non-CMT reduction group (P = 0.035). There was no correlation between changes in flare values and CMT either in the IVA or IVR group.
Flare value changes in patients treated with IVR decreased at day 14 post-injection. This may indicate when the most anti-inflammatory effect was obtained. There was no correlation between changes in flare values and CMT either in the IVA or IVR group; nevertheless, our research suggests that the baseline flare value is a predictive factor for the efficacy of IVA in DME.
评估抗血管内皮生长因子治疗糖尿病黄斑水肿(DME)后房水闪辉变化模式,并研究闪辉值变化与中心黄斑厚度(CMT)之间的关系。
回顾性、干预性病例系列研究
共有 62 例 DME 患者的 84 只眼接受了玻璃体内雷珠单抗(IVR;n=62)或阿柏西普(IVA;n=22)治疗。采用 Kowa FM500 激光闪辉光度计(Kowa Company,Ltd)测量闪辉值,并用光学相干断层扫描评估 CMT。在注射前(基线)及注射后 1、7 和 14 天测量闪辉值和 CMT。
IVR 组的闪辉值在第 14 天显著下降(P=0.001),而 IVA 组在第 1 天显著升高(P<0.001)。IVA 组中,CMT 减少组的基线闪辉值明显高于非 CMT 减少组(P=0.035)。IVA 组和 IVR 组中,闪辉值变化与 CMT 之间均无相关性。
接受 IVR 治疗的患者的闪辉值在注射后第 14 天下降。这可能表明获得了最大的抗炎效果的时间。IVA 组和 IVR 组中,闪辉值变化与 CMT 之间均无相关性;然而,我们的研究表明,基线闪辉值是 IVA 治疗 DME 疗效的预测因素。