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采用光相干断层扫描血管造影术观察抗血管内皮生长因子治疗慢性中心性浆液性脉络膜视网膜病变的短期疗效与脉络膜新生血管的关系。

Short-term effect of anti-VEGF for chronic central serous chorioretinopathy according to the presence of choroidal neovascularization using optical coherence tomography angiography.

机构信息

Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Republic of Korea.

出版信息

PLoS One. 2021 Jan 11;16(1):e0245342. doi: 10.1371/journal.pone.0245342. eCollection 2021.

Abstract

PURPOSE

To analyze the short-term therapeutic efficacy of intravitreal injection of bevacizumab (IVB) for chronic central serous chorioretinopathy (CSC) according to the presence of choroidal neovascularization (CNV) using optical coherence tomography angiography (OCTA).

METHODS

A retrospective chart review was perfomed on cases of CSC with CNV (Group 1: n = 31) and an age-matched cases of CSC without CNV (Group 2: n = 30). The response to IVB was evaluated by changes in best-corrected visual acuity (BCVA), central macular thickness (CMT), choroidal thickness (CT), and pachyvessel diameter. Univariate and multivariate linear regression analyses were performed to identify factors associated with the visual outcome of chronic CSC with CNV after IVB.

RESULTS

At baseline, the CT values differed significantly between Groups 1 and 2 (371.55 ± 67.09 vs. 417.33 ± 71.32 μm, p = 0.01). In Group 1, BCVA improved significantly (p < 0.001), and CMT (p < 0.001), CT (p = 0.001) and pachyvessel diameter (p = 0.045) decreased significantly, after IVB. In Group 2, only pachyvessel diameter (p = 0.001) was significantly smaller after IVB. Univariate analysis showed that the initial CT (B = 0.002, p = 0.026) and pachyvessel diameter (B = 0.002, p = 0.001) significantly affected visual outcome. In multivariate analysis, the initial pachyvessel diameter exhibited significant results (B = 0.002, p = 0.001).

CONCLUSIONS

IVB showed less effective short-term outcomes in chronic CSC patients without CNV than in patients with CNV. In chronic CSC with CNV, the short-term visual outcome after IVB was better in patients with a thinner choroid and smaller pachyvessels.

摘要

目的

利用光相干断层扫描血管造影(OCTA)分析脉络膜新生血管(CNV)存在情况下玻璃体内注射贝伐单抗(IVB)治疗慢性中心性浆液性脉络膜视网膜病变(CSC)的短期疗效。

方法

对 CNV 合并 CSC 患者(1 组,n=31)和年龄匹配的无 CNV 的 CSC 患者(2 组,n=30)进行回顾性图表分析。通过最佳矫正视力(BCVA)、中心黄斑厚度(CMT)、脉络膜厚度(CT)和厚血管直径的变化来评估 IVB 的反应。采用单变量和多变量线性回归分析来确定 IVB 后 CNV 合并慢性 CSC 视觉结果的相关因素。

结果

在基线时,1 组和 2 组的 CT 值差异有统计学意义(371.55±67.09 μm 与 417.33±71.32 μm,p=0.01)。1 组患者 IVB 后 BCVA 显著改善(p<0.001),CMT(p<0.001)、CT(p=0.001)和厚血管直径(p=0.045)显著降低。2 组患者 IVB 后仅厚血管直径(p=0.001)显著减小。单变量分析显示,初始 CT(B=0.002,p=0.026)和厚血管直径(B=0.002,p=0.001)显著影响视力结果。多变量分析显示,初始厚血管直径具有显著结果(B=0.002,p=0.001)。

结论

与 CNV 患者相比,无 CNV 的慢性 CSC 患者 IVB 的短期疗效较差。在 CNV 合并慢性 CSC 患者中,IVB 后短期视力结果更好的患者脉络膜更薄,厚血管更小。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2916/7799826/cfec3562da1c/pone.0245342.g001.jpg

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