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真实世界环境下视网膜静脉阻塞继发黄斑水肿:一项多中心、全国性、3 年随访研究。

Macular edema secondary to retinal vein occlusion in a real-life setting: a multicenter, nationwide, 3-year follow-up study.

机构信息

Ophthalmology Department, Hospital de Braga, Sete Fontes - São Vítor, 4710-243, Braga, Portugal.

Ophthalmology Department, Centro Hospitalar Universitário Lisboa Central, Alameda Santo António dos Capuchos, 1169-050, Lisboa, Portugal.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2021 Feb;259(2):343-350. doi: 10.1007/s00417-020-04932-0. Epub 2020 Sep 23.

Abstract

PURPOSE

To evaluate the presence of macular edema secondary to retinal vein occlusion (RVO)-both central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO)-3 years after diagnosis in patients who underwent intravitreal therapy and to identify potential prognostic factors and biomarkers of persistent macular edema.

METHODS

National multicenter, observational, exploratory, retrospective cohort study of 104 consecutive patients with macular edema secondary to RVO diagnosed from January 2014 to December 2015 with minimum 3-year follow-up time. Data analyzed included best-corrected visual acuity (BCVA), clinical and demographic data, and spectral domain optical coherence tomography parameters.

RESULTS

At final observation, median baseline central retinal thickness significantly improved from baseline 538 to 290 μm (p < 0.001) and complete macular edema resolution was achieved in 51.0% of patients (56.3% and 42.5% in BRVO and CRVO patients, respectively). BCVA also improved (p < 0.01). Logistic regression analysis revealed a relationship between recurrence of macular edema and disorganization of retinal inner layers (DRIL) at baseline (odds ratio = 2.88; p = 0.013).

CONCLUSION

Good long-term anatomical and functional outcomes are achieved with intravitreal treatments in RVO patients. Anatomical success and visual gains seen in the first year were maintained throughout the entire follow-up, though DRIL is a major risk factor for recurrence.

摘要

目的

评估视网膜静脉阻塞(RVO)-包括中央视网膜静脉阻塞(CRVO)和分支视网膜静脉阻塞(BRVO)-患者在接受玻璃体内治疗 3 年后是否存在继发于黄斑水肿的情况,并确定持续性黄斑水肿的潜在预后因素和生物标志物。

方法

这是一项全国多中心、观察性、探索性、回顾性队列研究,纳入了 2014 年 1 月至 2015 年 12 月期间诊断为 RVO 继发黄斑水肿的 104 例连续患者,随访时间至少为 3 年。分析的数据包括最佳矫正视力(BCVA)、临床和人口统计学数据以及光谱域光相干断层扫描参数。

结果

在最终观察时,基线中央视网膜厚度从基线时的 538 μm显著改善至 290 μm(p<0.001),51.0%的患者实现了完全黄斑水肿消退(BRVO 和 CRVO 患者分别为 56.3%和 42.5%)。BCVA 也有所改善(p<0.01)。逻辑回归分析显示,黄斑水肿复发与基线时视网膜内层紊乱(DRIL)之间存在关系(优势比=2.88;p=0.013)。

结论

玻璃体内治疗 RVO 患者可获得良好的长期解剖和功能结局。第一年观察到的解剖学成功和视力提高在整个随访期间得以维持,尽管 DRIL 是复发的主要危险因素。

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