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糖尿病性黄斑水肿患者经雷珠单抗治疗无效后接受地塞米松植入或阿柏西普治疗后的脉络膜厚度

Choroidal Thickness After Dexamethasone Implant or Aflibercept in Patients with Diabetic Macular Edema Persistent to Ranibizumab.

作者信息

Aksoy Mustafa, Yilmaz Gursel, Vardarli Irfan, Akkoyun Imren

机构信息

Department of Ophthalmology, Faculty of Medicine, Baskent University, Ankara, Turkey.

Department of Endocrinology, Knappschaftskrankenhaus, Klinikum Vest GmbH, Academic Teaching Hospital, Ruhr-University Bochum, Recklinghausen, Germany.

出版信息

J Ocul Pharmacol Ther. 2020 Oct;36(8):629-635. doi: 10.1089/jop.2020.0004. Epub 2020 May 27.

Abstract

This study aims to compare subfoveal choroidal thicknesses (SFCTs) after intravitreal dexamethasone (IVD) or intravitreal aflibercept (IVA) treatment in patients with persistent diabetic macular edema (DME) unresponsive to intravitreal ranibizumab (IVR). The study consisted of patients with DME unresponsive to IVR treatment in which 37 were administered 1 dose IVD (group A) and 34 patients who were administered 3 doses of IVA (group B), as well as 35 healthy individuals (group C). Detailed ophthalmological examination and optical coherence tomography parameters of group A and group B, including central retinal thickness and SFCT, were retrospectively evaluated before and after treatment. Results from preinjection, and 1, 2, and 3 months after injection were analyzed. Results of group A and group B were compared within themselves and also compared with group C. SFCT measurements were compared within group A and group B (1 = preinjection; 2 = 1 month postinjection; 3 = 2 months postinjection; 4 = 3 months postinjection). There was significant thinning in SFCT between 1-2, 1-3, 1-4, 2-3, 2-4, and 3-4 time intervals within both group A and group B (both  < 0.001). Comparison of SFCT measurements showed preinjection, 1-, and 2-month values of group A were significantly thicker than those of group C ( < 0.001), whereas there was no significant difference between 3-month values ( = 0.09). Preinjection, 1-, and 2-month values of group B were significantly thicker than those of group C ( < 0.001), whereas there was no significant difference between 3-month values ( = 0.06). Three month follow-up showed thinning in SFCT measurements in patients with persistent DME unresponsive to IVR who were applied IVD or IVA treatment.

摘要

本研究旨在比较玻璃体内注射地塞米松(IVD)或玻璃体内注射阿柏西普(IVA)治疗后,持续性糖尿病性黄斑水肿(DME)患者对玻璃体内注射雷珠单抗(IVR)无反应时的黄斑中心凹下脉络膜厚度(SFCT)。该研究纳入了对IVR治疗无反应的DME患者,其中37例接受1剂IVD治疗(A组),34例接受3剂IVA治疗(B组),以及35名健康个体(C组)。对A组和B组治疗前后的详细眼科检查和光学相干断层扫描参数,包括中心视网膜厚度和SFCT进行回顾性评估。分析注射前、注射后1、2和3个月的结果。将A组和B组的结果进行组内比较,并与C组进行比较。对A组和B组内的SFCT测量值进行比较(1 =注射前;2 =注射后1个月;3 =注射后2个月;4 =注射后3个月)。A组和B组在1 - 2、1 - 3、1 - 4、2 - 3、2 - 4和3 - 4时间间隔内的SFCT均有显著变薄(均P < 0.001)。SFCT测量值比较显示,A组注射前、1个月和2个月的值显著厚于C组(P < 0.001),而3个月的值无显著差异(P = 0.09)。B组注射前、1个月和2个月的值显著厚于C组(P < 0.001),而3个月的值无显著差异(P = 0.06)。3个月的随访显示,接受IVD或IVA治疗的对IVR无反应的持续性DME患者的SFCT测量值变薄。

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