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光学相干断层扫描血管造影术在比较多灶性脉络膜炎两种治疗策略中脉络膜毛细血管恢复情况的应用:一项初步临床试验

The use of optical coherence tomography angiography in comparing choriocapillaris recovery between two treatment strategies for multifocal choroiditis: a pilot clinical trial.

作者信息

Agarwal Aniruddha, Abhaypal Khushdeep, Aggarwal Kanika, Erckens Roel J, Berendschot Tos T J M, Webers C A B, Dogra Mohit, Bansal Reema, Gupta Vishali

机构信息

Eye Institute, Cleveland Clinic Abu Dhabi, Al Maryah Island, Abu Dhabi, United Arab Emirates.

Advanced Eye Center, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, India.

出版信息

J Ophthalmic Inflamm Infect. 2022 Mar 11;12(1):12. doi: 10.1186/s12348-022-00291-5.

Abstract

PURPOSE

To compare differences in choriocapillaris flow deficit (CC FD) in multifocal choroiditis (MFC) between two treatment arms using optical coherence tomography angiography (OCTA).

METHODS

In this prospective randomized clinical trial, patients were randomized to either Group 1 which received standard tapering dose of oral corticosteroids, or Group 2 which received additional dexamethasone implant (or intravitreal methotrexate). The patients were followed-up until 12 weeks using OCTA and other imaging tools. CC FD and visual acuity between the two groups were compared at each visit.

RESULTS

Twenty-five subjects (17 males; 25 eyes) were studied (11 eyes in Group 1). There were no differences between the visual acuity or CC FD (1.12 versus 1.08 mm; p = 0.86) at baseline between the groups. However, patients in Group 2 achieved better visual acuity (0.32 ± 0.23 versus 0.15 ± 0.11; p = 0.025) and CC FD (0.54 versus 0.15 mm; p = 0.008) at 12 weeks.

CONCLUSIONS

OCTA is a useful tool in monitoring the CC FD recovery after treatment in MFC. Patients receiving intravitreal corticosteroid/methotrexate in addition to systemic corticosteroid showed greater resolution of CC FD on OCTA compared to those receiving only oral corticosteroids.

摘要

目的

使用光学相干断层扫描血管造影(OCTA)比较多灶性脉络膜炎(MFC)两个治疗组中脉络膜毛细血管血流缺损(CC FD)的差异。

方法

在这项前瞻性随机临床试验中,患者被随机分为两组,第1组接受标准递减剂量的口服皮质类固醇,第2组接受额外的地塞米松植入物(或玻璃体内甲氨蝶呤)。使用OCTA和其他成像工具对患者进行随访至12周。每次就诊时比较两组之间的CC FD和视力。

结果

研究了25名受试者(17名男性;25只眼)(第1组11只眼)。两组之间基线时的视力或CC FD(1.12对1.08毫米;p = 0.86)无差异。然而,第2组患者在12周时达到了更好的视力(0.32±0.23对0.15±0.11;p = 0.025)和CC FD(0.54对0.15毫米;p = 0.008)。

结论

OCTA是监测MFC治疗后CC FD恢复的有用工具。与仅接受口服皮质类固醇的患者相比,除全身皮质类固醇外还接受玻璃体内皮质类固醇/甲氨蝶呤的患者在OCTA上显示出CC FD的更大程度的消退。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/326a/8917244/eca3a6c41852/12348_2022_291_Fig1_HTML.jpg

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