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玻璃黄斑牵引定量截点评估 ocriplasmin 玻璃体内治疗后的缓解情况。

Vitreomacular traction quantitative cutoffs for the assessment of resolution after ocriplasmin intravitreal treatment.

机构信息

Department of Ophthalmology, IRCCS Ospedale San Raffaele, University Vita-Salute, Via Olgettina 60, 20132, Milan, Italy.

IRCCS Centro Bonino-Pulejo Neurolesi, Messina, Italy.

出版信息

Sci Rep. 2020 Oct 16;10(1):17583. doi: 10.1038/s41598-020-74472-4.

Abstract

This study aimed to assess optical coherence tomography (OCT) parameters associated with vitreomacular traction (VMT) resolution after ocriplasmin intravitreal injection and also associated with the development of vitreomacular complications. Study designed was a retrospective case series. Structural OCT images were acquired at baseline and over the follow-up after treatment. We developed a mathematical model to provide quantitative parameters associated with VMT resolution. Moreover, we adopted the same model to assess the quantitative parameters associated with development of further vitreomacular complications or with the worsening of the coexisting condition. Main outcome measures were BCVA, central macular thickness (CMT), VMT reflectivity, VMT size, VMT resolution, epiretinal membrane (ERM), macular holes. 73 eyes of 73 VMT patients (mean age 73 ± 9 years) were recruited. The mean follow-up duration was 2.6 ± 1.1 years. Mean baseline BCVA was 0.38 ± 0.18 LogMAR, improving to 0.26 ± 0.20 at the end of the follow-up (p < 0.01). Baseline CMT was 431 ± 118 µm, improving to 393 ± 122 µm at the end of the follow-up (p < 0.01). 38/73 eyes (52%) showed only VMT, whereas 35/73 eyes (48%) also showed coexisting alterations at baseline. VMT resolved in 40/73 eyes (55% of cases). Our model disclosed VMT reflectivity as the most involved parameter in VMT resolution. VMT size showed less influence on the success of ocriplasmin treatment. ERM was negatively associated with VMT resolution. Moreover, VMT reflectivity values and ERM represented the most important parameters for the onset of vitreomacular complications.

摘要

本研究旨在评估玻璃体内注射 ocriplasmin 后玻璃体黄斑牵引(VMT)缓解与 VMT 相关的光相干断层扫描(OCT)参数,并评估与玻璃体黄斑并发症发生相关的参数。研究设计为回顾性病例系列。在基线和治疗后随访时采集结构 OCT 图像。我们开发了一个数学模型,提供与 VMT 缓解相关的定量参数。此外,我们采用相同的模型评估与进一步发生玻璃体黄斑并发症或共存疾病恶化相关的定量参数。主要观察指标为最佳矫正视力(BCVA)、中央黄斑厚度(CMT)、VMT 反射率、VMT 大小、VMT 缓解、视网膜内膜(ERM)、黄斑裂孔。纳入 73 例(73 只眼)VMT 患者(平均年龄 73±9 岁)。平均随访时间为 2.6±1.1 年。平均基线 BCVA 为 0.38±0.18 LogMAR,随访结束时提高至 0.26±0.20(p<0.01)。基线 CMT 为 431±118µm,随访结束时降至 393±122µm(p<0.01)。38/73 只眼(52%)仅表现为 VMT,而 35/73 只眼(48%)基线时还存在共存改变。73 只眼中的 40 只(55%)眼 VMT 缓解。我们的模型显示 VMT 反射率是 VMT 缓解中最相关的参数。VMT 大小对 ocriplasmin 治疗的疗效影响较小。ERM 与 VMT 缓解呈负相关。此外,VMT 反射率值和 ERM 是发生玻璃体黄斑并发症的最重要参数。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76d1/7567872/8d9528f4fa2d/41598_2020_74472_Fig1_HTML.jpg

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