Liu Bing, Ma Guangfeng, Hou Jing, Cong Chenyang
Department of Ophthalmology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250033, China.
Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250002, China.
J Ophthalmol. 2022 Feb 21;2022:6882607. doi: 10.1155/2022/6882607. eCollection 2022.
To access the choroidal structural changes of posterior subtenon triamcinolone acetonide (PSTA) injection in eyes with refractory diabetic macular edema (DME).
Patients with refractory DME were enrolled and followed for 4 weeks after switching to PSTA injection. All patients underwent spectral-domain optical coherence tomography with enhanced depth imaging, and the choroidal images were binarized into the luminal area and total choroidal area. Subfoveal choroidal thickness (SFCT) and choroidal vascularity index (CVI) were evaluated before and after switching treatments.
After switching to PSTA treatment, the final best-corrected visual acuity and central subfield thickness in eyes with refractory DME were significantly improved compared to the baseline values (=0.002 and < 0.001, respectively). Both the SFCT and CVI decreased during the follow-up period, and significant decreases were observed at 4-week follow-up ( < 0.001 and =0.012, respectively). The linear regression analysis showed a significant correlation between the baseline SFCT and the final visual outcomes (=0.047).
The alterations of SFCT and CVI in this study suggest that the choroidal vasculature is involved in the pathogenesis of refractory DME and could be affected by PSTA treatment. SFCT rather than CVI may be a prognostic biomarker for eyes with refractory DME.
评估难治性糖尿病性黄斑水肿（DME）患者眼内后Tenon囊下注射曲安奈德（PSTA）后的脉络膜结构变化。
纳入难治性DME患者，在改用PSTA注射后随访4周。所有患者均接受了增强深度成像的光谱域光学相干断层扫描，脉络膜图像被二值化为管腔面积和脉络膜总面积。在转换治疗前后评估黄斑中心凹下脉络膜厚度（SFCT）和脉络膜血管指数（CVI）。
改用PSTA治疗后，难治性DME患者的最终最佳矫正视力和中心子野厚度与基线值相比显著改善（分别为=0.002和<0.001）。随访期间SFCT和CVI均下降，在4周随访时观察到显著下降（分别为<0.001和=0.012）。线性回归分析显示基线SFCT与最终视力结果之间存在显著相关性（=0.047）。
本研究中SFCT和CVI的改变表明脉络膜血管系统参与了难治性DME的发病机制，并且可能受PSTA治疗的影响。对于难治性DME患者，SFCT而非CVI可能是一种预后生物标志物。
