Department of Ophthalmology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, China.
Medicine (Baltimore). 2023 Jan 27;102(4):e32815. doi: 10.1097/MD.0000000000032815.
To evaluate the effect of intravitreal aflibercept on different classifications of diabetic macular edema (DME) by spectral-domain optical coherence tomography. This hospital-based retrospective study included 95 consecutive patients (130 eyes) diagnosed with DME. Three groups were defined: diffuse retinal thickening (DRT), cystoid macular edema and serous retinal detachment. All eyes received intravitreal aflibercept (0.05 mL/2 mg) 5 times monthly. Best corrected visual acuity (BCVA) in (logarithm of the minimum angle of resolution) units and central macular thickness (CMT) on optical coherence tomography were recorded at months 1, 2, 3, 4, 6, and 12 after the injections. There was no significant baseline difference in BCVA (P = .273) or CMT (P = .115) among the 3 groups. Over 12 months, the BCVA of the DRT group significantly improved from baseline (P = .013). The BCVA of the cystoid macular edema (P = .062) and serous retinal detachment groups (P = .073) improved slightly from baseline. The DRT group had the greatest BCVA improvement (P = .021). Over 12 months, the CMTs of all 3 groups significantly decreased from baseline (P = .016, P = .025, P = .031). The CMT decreased more in the DRT group than in the other 2 groups (P = .009). The CMT changes were most evident in the DRT group (P = .022). Binary logistic regression analysis showed that DME type, disorganization of the retinal inner layers, ellipsoid zone disruption and external limiting membrane disruption independently predicted the effect of aflibercept treatment in DME patients (P = .006, P = .001, P = .004, P = .001). Aflibercept therapy improved anatomical structure and visual acuity in every type of DME; DRT responded best in terms of both BCVA and CMT. Furthermore, DME, disorganization of the retinal inner layers, external limiting membrane disruption and ellipsoid zone disruption independently predicted the effect of aflibercept treatment in DME patients.
为了评估玻璃体内注射阿柏西普对不同分类的糖尿病性黄斑水肿（DME）的影响，本研究回顾性分析了 95 例（130 只眼）确诊为 DME 的患者。将患者分为弥漫性视网膜增厚（DRT）、囊样黄斑水肿和浆液性视网膜脱离 3 组。所有患者均接受玻璃体内注射阿柏西普（0.05ml/2mg），每月 5 次。在注射后第 1、2、3、4、6 和 12 个月记录最佳矫正视力（logMAR 单位）和光学相干断层扫描（OCT）的中心黄斑厚度（CMT）。3 组患者的基线最佳矫正视力（BCVA）（P=0.273）或 CMT（P=0.115）无显著差异。在 12 个月内，DRT 组的 BCVA 从基线显著改善（P=0.013）。囊样黄斑水肿（P=0.062）和浆液性视网膜脱离组（P=0.073）的 BCVA 从基线略有改善。DRT 组的 BCVA 改善最明显（P=0.021）。在 12 个月内，所有 3 组的 CMT 均从基线显著降低（P=0.016，P=0.025，P=0.031）。DRT 组的 CMT 下降幅度大于其他 2 组（P=0.009）。DRT 组的 CMT 变化最明显（P=0.022）。二项逻辑回归分析显示，DME 类型、视网膜内层紊乱、椭圆体带破坏和外界膜破坏独立预测了 DME 患者阿柏西普治疗的效果（P=0.006，P=0.001，P=0.004，P=0.001）。阿柏西普治疗改善了每种类型 DME 的解剖结构和视力；DRT 在 BCVA 和 CMT 方面的反应最好。此外，DME、视网膜内层紊乱、外界膜破坏和椭圆体带破坏独立预测了 DME 患者阿柏西普治疗的效果。
