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抗血管内皮生长因子和抗炎治疗后视网膜静脉阻塞继发黄斑水肿的光学相干断层扫描生物标志物变化。

Changes of Optical Coherence Tomography Biomarkers in Macular Edema Secondary to Retinal Vein Occlusion After Anti-VEGF and Anti-Inflammatory Therapies.

机构信息

Department of Ophtalmology, Henan Eye Hospital, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China.

Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People' s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China.

出版信息

Drug Des Devel Ther. 2022 Mar 15;16:717-725. doi: 10.2147/DDDT.S351683. eCollection 2022.

Abstract

PURPOSE

This study aimed to assess the short-term changes of macular microstructures following anti-VEGF and anti-inflammatory therapies in patients with macular edema secondary to retinal vein occlusion (RVO-ME).

PATIENTS AND METHODS

In this retrospective study, 70 eyes of 70 patients with RVO-ME were divided into the anti-VEGF (Group A, 35 eyes) and anti-inflammatory (Group B, 35 eyes) treatment groups. All patients underwent best-corrected visual acuity (BCVA) assessment, intraocular pressure (IOP) assessment, slit lamp, fundus fluorescein angiography (FA), scanning laser ophthalmoscopy (SLO), and spectral-domain optical coherence tomography (SD-OCT). Group A received intravitreal injection of 0.05 mL anti-VEGF antibodies (Lucentis or Aflibercept) monthly for 3 consecutive months, while Group B received 0.7 mg dexamethasone (Ozurdex) single intravitreal injection. BCVA and SD-OCT biomarkers were recorded at baseline and 3 months after the first injection. Changes of BCVA and SD-OCT biomarkers following these treatments were compared between the two groups.

RESULTS

BCVA and SD-OCT biomarkers, except choroidal thickness, in both groups were significantly improved after treatment (all < 0.01). At 3 months, the height of serous retinal detachment (SRD) was markedly lower ( = 0.006), with significantly less hyperreflective dots (HRD, = 0.037) in Group B compared with Group A. Other SD-OCT biomarkers and BCVA were not significantly different between the two groups (all > 0.05).

CONCLUSION

Anti-VEGF and anti-inflammatory therapies are both effective in RVO-ME, with improvement in BCVA and SD-OCT biomarkers. Anti-inflammatory therapy may be more effective than anti-VEGF therapy in SRD and HRD resolution.

摘要

目的

本研究旨在评估抗血管内皮生长因子(VEGF)和抗炎治疗对视网膜静脉阻塞(RVO)继发黄斑水肿(RVO-ME)患者黄斑微观结构的短期变化。

方法

在这项回顾性研究中,70 例 RVO-ME 患者的 70 只眼分为抗 VEGF 治疗组(A 组,35 只眼)和抗炎治疗组(B 组,35 只眼)。所有患者均进行最佳矫正视力(BCVA)评估、眼压(IOP)评估、裂隙灯检查、眼底荧光素血管造影(FA)、扫描激光检眼镜(SLO)和频域光学相干断层扫描(SD-OCT)。A 组患者每月接受 0.05ml 抗 VEGF 抗体(Lucentis 或 Aflibercept)玻璃体腔内注射,连续 3 个月;B 组患者接受 0.7mg 地塞米松(Ozurdex)单次玻璃体腔内注射。在基线和首次注射后 3 个月记录 BCVA 和 SD-OCT 生物标志物。比较两组患者治疗后 BCVA 和 SD-OCT 生物标志物的变化。

结果

两组患者的 BCVA 和 SD-OCT 生物标志物(脉络膜厚度除外)在治疗后均显著改善(均<0.01)。治疗 3 个月后,B 组患者的浆液性视网膜脱离(SRD)高度明显降低(=0.006),高反射点(HRD)明显减少(=0.037)。与 A 组相比,两组间其他 SD-OCT 生物标志物和 BCVA 差异均无统计学意义(均>0.05)。

结论

抗 VEGF 和抗炎治疗对 RVO-ME 均有效,均可改善 BCVA 和 SD-OCT 生物标志物。与抗 VEGF 治疗相比,抗炎治疗可能更有利于 SRD 和 HRD 的消退。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a15e/8934115/7754a6d413d9/DDDT-16-717-g0001.jpg

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