Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
BMJ Open Ophthalmol. 2023 Feb;8(1). doi: 10.1136/bmjophth-2022-001214.
BACKGROUND/AIMS: To characterise the baseline prevalence of subretinal fluid (SRF) and its effects on anatomical and visual acuity (VA) outcomes in diabetic macular oedema (DME) and retinal vein occlusion (RVO) following anti-vascular endothelial growth factor (VEGF).
This is a retrospective cohort study of 122 DME and 54 RVO patients who were initiated on anti-VEGF therapy with real-world variable dosing. The DME and RVO cohorts were subclassified based on the presence of SRF at presentation. Snellen VA was measured and converted to logarithm of the minimum angle of resolution (LogMAR). Changes in VA and central subfield thickness (CST) were assessed up to 24 months.
SRF was present in 22% and 41% in DME and RVO patients, respectively. In the DME subcohort, eyes with SRF showed an improvement of 0.166 logMAR (1.7 Snellen chart lines) at 12 months and 0.251 logMAR (2.6 Snellen chart lines) at 24 months, which were significantly greater compared with those of the non-SRF group. A significantly greater reduction in CST was noted in the SRF eyes compared with the non-SRF eyes at 3 months and 1 month in the DME and RVO subcohorts, respectively.
Baseline SRF is a good marker for a greater reduction in CST in both DME and RVO, but an improvement in VA associated with SRF may be only noted in DME.
背景/目的：本研究旨在描述糖尿病性黄斑水肿（DME）和视网膜静脉阻塞（RVO）患者接受抗血管内皮生长因子（VEGF）治疗后，基线期视网膜下液（SRF）的患病率及其对解剖和视力（VA）结局的影响。
这是一项回顾性队列研究，纳入了 122 例 DME 患者和 54 例 RVO 患者，这些患者接受了抗 VEGF 治疗，药物剂量根据实际情况进行了调整。根据患者基线期是否存在 SRF，将 DME 和 RVO 队列进行了分类。采用 Snellen 视力表测量 VA，并将其转换为最小分辨角对数（LogMAR）。评估了治疗后 24 个月内 VA 和中央视网膜神经纤维层厚度（CST）的变化情况。
DME 和 RVO 患者的 SRF 患病率分别为 22%和 41%。在 DME 亚组中，SRF 眼在 12 个月时 VA 改善了 0.166 LogMAR（1.7 个 Snellen 图表线），在 24 个月时 VA 改善了 0.251 LogMAR（2.6 个 Snellen 图表线），与无 SRF 组相比，改善更为显著。与无 SRF 眼相比，DME 和 RVO 亚组中 SRF 眼在 3 个月和 1 个月时 CST 分别有更显著的下降。
基线期 SRF 是 DME 和 RVO 患者 CST 更显著下降的良好标志物，但与 SRF 相关的 VA 改善可能仅在 DME 中观察到。
