抗血管内皮生长因子治疗伴或不伴青光眼的视网膜分支静脉阻塞性黄斑水肿——青光眼是否会影响抗VEGF注射后视网膜分支静脉阻塞性黄斑水肿患者的视力预后？
Anti-Vascular Endothelial Growth Factor Treatment for Macular Edema in Eyes with Branch Retinal Vein Occlusion with vs Without Glaucoma - Does Glaucoma Affect Visual Outcome in Eyes with BRVO-ME After antiVEGF Injections?
作者信息
Asami Shin, Sugimoto Masahiko, Tsukitome Hideyuki, Kato Kumiko, Matsubara Hisashi, Kondo Mineo
机构信息
Department of Ophthalmology, Mie University Graduate School of Medicine, Tsu, Mie, Japan.
出版信息
Clin Ophthalmol. 2022 Jul 15;16:2275-2283. doi: 10.2147/OPTH.S356727. eCollection 2022.
PURPOSE
To compare the therapeutic effects of anti-vascular endothelial growth factor (anti-VEGF) agents in eyes with macular edema associated with branch retinal vein occlusion (BRVO-ME) with glaucoma to those without glaucoma.
PATIENTS AND METHODS
This retrospective study was conducted using the medical records of Mie University Hospital from 2013 to 2017. Patients were recruited if they had received anti-VEGF agents for BRVO-ME treatment and included 30 patients (30 eyes) without glaucoma (G[-] group) and 27 patients (27 eyes) with glaucoma (G[+] group). The central retinal thickness (CRT) and best-corrected visual acuity (BCVA) at 3 months after a single injection of anti-VEGF agents were compared between the two groups.
RESULTS
Before treatment, the mean±standard deviation of the CRT was 514.2±117.3 μm for the G[-] group, which was not significantly different from that for the G[+] group (533.4±171.4 μm). The CRT in the G[-] and G[+] groups significantly reduced to 321.1±114.6 μm and 347.8±134.7 μm, respectively, at 1 month after the injection and to 360.4±159.5 μm and 352.4±151.9 μm, respectively, at 3 months after the injection (<0.01 for each group). The difference in the degree of CRT reduction between the two groups was not significant. Before treatment, the BCVA was 0.42±0.32 logMAR units in the G[-] group and 0.57±0.33 logMAR units in the G[+] group, showing no significant difference. The BCVA in the G[-] and G[+] groups improved significantly to 0.27±0.26 logMAR units and 0.34±0.42 logMAR units, respectively, at 1 month, and to 0.18±0.20 logMAR units and 0.39±0.34 logMAR units, respectively, at 3 months (<0.01). The BCVA in the G[-] group was significantly better than that in the G[+] group at 3 months (=0.02).
CONCLUSION
The therapeutic response of anti-VEGF agents for BRVO-ME is affected by the presence of glaucoma.
目的
比较抗血管内皮生长因子（anti-VEGF）药物对视网膜分支静脉阻塞相关性黄斑水肿合并青光眼（BRVO-ME）患者与不合并青光眼患者眼睛的治疗效果。
患者与方法
本回顾性研究使用了三重大学医院2013年至2017年的病历。纳入接受抗VEGF药物治疗BRVO-ME的患者，包括30例无青光眼患者（30只眼）（G[-]组）和27例青光眼患者（27只眼）（G[+]组）。比较两组单次注射抗VEGF药物后3个月时的中心视网膜厚度（CRT）和最佳矫正视力（BCVA）。
结果
治疗前，G[-]组CRT的平均值±标准差为514.2±117.3μm，与G[+]组（533.4±171.4μm）无显著差异。注射后1个月，G[-]组和G[+]组的CRT分别显著降至321.1±114.6μm和347.8±134.7μm，注射后3个月分别降至360.4±159.5μm和352.4±151.9μm（每组P<0.01）。两组CRT降低程度的差异不显著。治疗前，G[-]组的BCVA为0.42±0.32 logMAR单位，G[+]组为0.57±0.33 logMAR单位，无显著差异。G[-]组和G[+]组的BCVA在1个月时分别显著改善至0.27±0.26 logMAR单位和0.34±0.42 logMAR单位，在3个月时分别改善至0.18±0.20 logMAR单位和0.39±0.34 logMAR单位（P<0.01）。3个月时，G[-]组的BCVA显著优于G[+]组（P=0.02）。
结论
抗VEGF药物对BRVO-ME的治疗反应受青光眼的影响。
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