Department of Ophthalmology, Meir Medical Center, Kfar Sava and the Sackler School of Medicine, Tel Aviv University, Kfar Saba, 44281, Israel.
Department of Ophthalmology, Rambam Health Care Campus and the Technion-Israel Institute of Technology, Haifa, Israel.
Int Ophthalmol. 2021 Feb;41(2):533-540. doi: 10.1007/s10792-020-01604-0. Epub 2020 Oct 22.
To identify baseline optical coherence tomography (OCT) factors in ischemic central retinal vein occlusion (CRVO) that predict response to bevacizumab injections.
Patients underwent OCT at diagnosis and the central macular thickness, subretinal fluid width and height as well as the presence of intraretinal cysts were measured. The extent of disorganized retinal inner layers, outer plexiform layer (OPL), external limiting membrane, ellipsoid zone and cone outer segment tips (COST) was recorded. Patients received three consecutive monthly injections of bevacizumab followed by pro re nata treatment.
Overall 32 eyes of 32 patients aging 69.4 ± 12.7 years were included. In univariate correlational analyses baseline OPL disruption (- 41, p = 0.02), EZ disruption (r = - 0.36, p = 0.05) and COST disruption (r = - 0.37, p = 0.04) correlated with deterioration in BCVA at 1 year. Partial least squares demonstrated that the factors most largely associated with deterioration in BCVA were COST disruption and OPL disruption followed by EZ disruption, while worst vision at baseline was associated with improvement in vision.
In patients with ischemic CRVO treated with bevacizumab, BCVA improvement at 1 year can be partially predicted from baseline OCT measurements by the extent of COST, OPL and EZ disruption.
确定缺血性视网膜中央静脉阻塞（CRVO）中基线光学相干断层扫描（OCT）的因素，这些因素可预测对贝伐单抗注射的反应。
患者在诊断时接受 OCT 检查，并测量中央黄斑厚度、视网膜下液宽度和高度以及是否存在视网膜内囊肿。记录视网膜内层、外丛状层（OPL）、外界膜、椭圆体带和圆锥外节尖端（COST）的紊乱程度。患者接受了三次连续每月的贝伐单抗注射，然后进行了按需治疗。
共纳入 32 名年龄 69.4±12.7 岁的 32 只眼的患者。在单变量相关分析中，基线 OPL 中断（-41，p=0.02）、EZ 中断（r=-0.36，p=0.05）和 COST 中断（r=-0.37，p=0.04）与 1 年后 BCVA 的恶化相关。偏最小二乘法表明，与 BCVA 恶化最相关的因素是 COST 中断和 OPL 中断，其次是 EZ 中断，而基线时最差的视力与视力改善相关。
在接受贝伐单抗治疗的缺血性 CRVO 患者中，通过 COST、OPL 和 EZ 中断的程度，可以从基线 OCT 测量中部分预测 1 年后的 BCVA 改善。
