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真实世界中视网膜中央静脉和分支静脉阻塞的管理:一项为期七年的随访研究。

Real-Life Management of Central and Branch Retinal Vein Occlusion: A Seven-Year Follow-Up Study.

机构信息

Department of Ophthalmology, IRCCS San Raffaele Hospital, University Vita-Salute, Milan, Italy.

出版信息

Thromb Haemost. 2021 Oct;121(10):1361-1366. doi: 10.1055/s-0041-1725197. Epub 2021 Mar 11.

DOI:10.1055/s-0041-1725197
PMID:33706397
Abstract

Retinal vein occlusion is the second most common retinal vascular pathology after diabetic retinopathy and a major cause of vision impairment. Nowadays, both central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO) can be well-managed by intravitreal treatments. However, considering the long-life expectance of the patients, few data are present in the literature about the very long-term outcome of CRVO and BRVO. The present study was an interventional, retrospective analysis of the morphological and functional long-term outcome of CRVO and BRVO patients, followed in an Italian referral center. We collected data from 313 eyes (178 CRVO eyes and 135 BRVO eyes). Mean follow-up was 45 ± 25 months (range 12-84 months). Both CRVO and BRVO eyes experience a significant visual acuity improvement secondary to anti-vascular endothelial growth factor/dexamethasone treatments (from 0.57 ± 0.25 to 0.41 ± 0.24 LogMAR in CRVO and from 0.53 ± 0.42 to 0.30 ± 0.41 LogMAR in BRVO, respectively) ( < 0.01). Also, central macular thickness (CMT) resulted significant recovery at the end of the follow-up (from 585.54 ± 131.43 to 447.88 ± 245.07 μm in CRVO and from 585.54 ± 131.43 to 447.88 ± 245.07 μm in BRVO, respectively) ( < 0.01). CRVO eyes received a mean of 10.70 ± 4.76 intravitreal treatments, whereas BRVO underwent 9.80 ± 5.39 injections over the entire 7-year follow-up. Our analyses highlighted different time points indicating the best obtainable improvement. This was the first year for CRVO (12-month follow-up) and the second year for BRVO (24-month follow-up). After these two time points, both visual acuity and CMT resulted stable up to the end of the follow-up. Ischemia was associated with significantly worse outcome.

摘要

视网膜静脉阻塞是仅次于糖尿病性视网膜病变的第二大常见视网膜血管病变,也是视力损害的主要原因。如今,通过玻璃体内治疗可以很好地治疗中央视网膜静脉阻塞(CRVO)和分支视网膜静脉阻塞(BRVO)。然而,考虑到患者的预期寿命较长,关于 CRVO 和 BRVO 的非常长期结果的文献数据很少。本研究是对在意大利转诊中心接受治疗的 CRVO 和 BRVO 患者的形态和功能长期结果进行的一项干预性、回顾性分析。我们收集了 313 只眼睛(178 只 CRVO 眼和 135 只 BRVO 眼)的数据。平均随访时间为 45±25 个月(范围 12-84 个月)。CRVO 和 BRVO 眼都因抗血管内皮生长因子/地塞米松治疗而视力显著提高(CRVO 从 0.57±0.25 提高到 0.41±0.24 LogMAR,BRVO 从 0.53±0.42 提高到 0.30±0.41 LogMAR)( <0.01)。此外,中央视网膜厚度(CMT)在随访结束时也有显著恢复(CRVO 从 585.54±131.43 降低到 447.88±245.07 μm,BRVO 从 585.54±131.43 降低到 447.88±245.07 μm)( <0.01)。CRVO 眼平均接受 10.70±4.76 次玻璃体内治疗,而 BRVO 在整个 7 年的随访中接受了 9.80±5.39 次注射。我们的分析强调了不同的时间点,可以达到最佳的改善效果。这对于 CRVO 是第一年(12 个月随访),对于 BRVO 是第二年(24 个月随访)。在这两个时间点之后,视力和 CMT 结果一直稳定到随访结束。缺血与预后显著恶化相关。

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