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影响糖尿病性黄斑水肿抗VEGF治疗短期反应的因素

Factors Affecting a Short-Term Response to Anti-VEGF Therapy in Diabetic Macular Edema.

作者信息

Usui-Ouchi Ayumi, Tamaki Asaka, Sakanishi Yoshihito, Tamaki Kazunori, Mashimo Keitaro, Sakuma Toshiro, Ebihara Nobuyuki

机构信息

Department of Ophthalmology, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba 279-0021, Japan.

出版信息

Life (Basel). 2021 Jan 25;11(2):83. doi: 10.3390/life11020083.

Abstract

Diabetic macular edema (DME) is a common cause of visual impairment in patients with diabetes. Although intravitreal anti-vascular endothelial growth factor (VEGF) injections were efficacious in clinical trials, several patients exhibited a poor response. This study aimed to compare clinical features between patients who were susceptible to intravitreal anti-VEGF injections for DME and those who were not. A single-center, retrospective study of 102 such patients was conducted (123 eyes; mean ± standard deviation age, 63.4 ± 10.8 years; 57.8% males). Systemic and ocular data, assessed at baseline and after a month, were compared between good (>20% decrease in central macular thickness (CMT)) and poor (≤20% decrease in CMT) responders using the Mann-Whitney U test/Fisher's exact test. Eighty-one eyes (65.9%) were good responders. The glycosylated hemoglobin level was higher ( = 0.011) in poor (7.5% ± 0.94%) than in good (7.04% ± 1.19%) responders. The foveal avascular zone was larger ( = 0.0003) in poor (0.67 ± 0.33 μm) than in good (0.47 ± 0.23 μm) responders. The number of microaneurysms in the pericapillary network was higher ( = 0.0007) in poor (2.7 ± 2.2) than in good (1.4 ± 2.0) responders. Baseline glycemic control and macular ischemia may be associated with the short-term response to intravitreal anti-VEGF injections.

摘要

糖尿病性黄斑水肿(DME)是糖尿病患者视力损害的常见原因。尽管玻璃体内注射抗血管内皮生长因子(VEGF)在临床试验中有效,但仍有部分患者反应不佳。本研究旨在比较对DME进行玻璃体内抗VEGF注射敏感的患者与不敏感患者的临床特征。对102例此类患者(123只眼;平均年龄±标准差为63.4±10.8岁;男性占57.8%)进行了单中心回顾性研究。使用Mann-Whitney U检验/Fisher精确检验,比较了在基线和一个月后评估的全身和眼部数据,将反应良好(中心黄斑厚度(CMT)降低>20%)和反应不佳(CMT降低≤20%)的患者进行对比。81只眼(65.9%)反应良好。反应不佳者(7.5%±0.94%)的糖化血红蛋白水平高于反应良好者(7.04%±1.19%)(P = 0.011)。反应不佳者(0.67±0.33μm)的黄斑无血管区比反应良好者(0.47±0.23μm)更大(P = 0.0003)。毛细血管周网络中的微动脉瘤数量,反应不佳者(2.7±2.2)高于反应良好者(1.4±2.0)(P = 0.0007)。基线血糖控制和黄斑缺血可能与玻璃体内抗VEGF注射的短期反应有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/250c/7912394/72e6ccb3aa89/life-11-00083-g001.jpg

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