Department of Ophthalmology, Adana City Training and Research Hospital, Adana, Turkey.
Arq Bras Oftalmol. 2020 Sep-Oct;83(5):372-377. doi: 10.5935/0004-2749.20200045.
To assess tomographic ganglion cell complex changes in patients with diabetic macular edema treated with intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF).
We analyzed data from 35 eyes of 35 previously untreated patients in whom diabetic macular edema improved after three loading doses of anti-VEGF injection and who did not receive repeated injections. We recorded spectral domain-optical coherence tomography assessments of ganglion cell complex and central macular thickness at baseline and monthly for three months, and on the sixth and ninth month after treatment. We compared the results with those of the unaffected eyes in the same patients and with those in a control group of patients with diabetic macular edema who were untreated.
The mean age of the patients in the treatment group was 60 ± 4.38 years. The foveal thicknesses measured using optical coherence tomography decreased significantly from baseline to the third month post-injection (p<0.05). The mean ganglion cell complex thickness was 115.08 ± 16.72 µm before the first injection and 101.05 ± 12.67 µm after the third injection (p<0.05). The mean ganglion cell complex was 110.04 ± 15.07 µm on the sixth month (p>0.05) and 113.12 ± 11.15 µm on the ninth month (p>0.05). We found a significant difference between the patients and the control group in terms of mean ganglion cell complex thickness on the second- and third-months post-injection (p<0.05).
Our study showed that the ganglion cell complex thickness in patients with diabetic macular edema decreased after the anti-VEGF injections. We cannot ascertain whether the ganglion cell complex thickness decreases were due to effects of the anti-VEGF agents or to the natural disease course.
评估玻璃体内注射抗血管内皮生长因子（anti-VEGF）治疗糖尿病黄斑水肿患者的断层成像神经节细胞复合体变化。
我们分析了 35 名未经治疗的患者的 35 只眼的数据，这些患者在接受三次抗 VEGF 注射负荷剂量后，糖尿病黄斑水肿得到改善，且未接受重复注射。我们记录了基线时和治疗后第 1、2、3、6 和 9 个月时的神经节细胞复合体和中央黄斑厚度的光谱域光学相干断层扫描评估结果。我们将结果与同一患者未受影响眼的结果和未经治疗的糖尿病黄斑水肿患者的对照组进行了比较。
治疗组患者的平均年龄为 60 ± 4.38 岁。光学相干断层扫描测量的黄斑中心凹厚度从基线到注射后第 3 个月显著降低（p<0.05）。第一次注射前平均神经节细胞复合体厚度为 115.08 ± 16.72 µm，第三次注射后为 101.05 ± 12.67 µm（p<0.05）。第 6 个月平均神经节细胞复合体为 110.04 ± 15.07 µm（p>0.05），第 9 个月为 113.12 ± 11.15 µm（p>0.05）。我们发现注射后第 2 和第 3 个月患者与对照组之间的平均神经节细胞复合体厚度存在显著差异（p<0.05）。
我们的研究表明，玻璃体内注射抗 VEGF 后糖尿病黄斑水肿患者的神经节细胞复合体厚度降低。我们无法确定神经节细胞复合体厚度的降低是由于抗 VEGF 药物的作用还是由于自然病程。
