Ophthalmic Surg Lasers Imaging Retina. 2023 Aug;54(8):454-460. doi: 10.3928/23258160-20230615-02. Epub 2023 Aug 1.
Macular thickness fluctuations (MTF) over time may be more predictive of visual outcomes than absolute macular thickness in patients with diabetic macular edema (DME) treated with anti-vascular endothelial growth factor (anti-VEGF). It is unclear whether this association exists in DME patients treated with intravitreal steroids or whether steroids confer reduced MTF versus anti-VEGF treatments.
MTF was compared before and after initiation of steroids in DME patients treated with intravitreal steroids. A mixed-effects linear regression model was used to determine the association between MTF and best-corrected visual acuity (BCVA).
Mean 12-month MTF significantly decreased after steroid initiation (61.1 μm versus 53.5 μm, = 0.04, = 105 eyes). Mean BCVA after 12 months was not significantly different from baseline. No significant association between post-steroid MTF and 12-month BCVA was found.
Steroid treatment decreases MTF while BCVA remains stable in DME patients previously treated with anti-VEGF. .
与糖尿病性黄斑水肿（DME）患者接受抗血管内皮生长因子（抗 VEGF）治疗相比，黄斑厚度波动（MTF）随时间的变化可能更能预测视力结果，而不是绝对黄斑厚度。目前尚不清楚这种关联是否存在于接受玻璃体内皮质类固醇治疗的 DME 患者中，或者皮质类固醇是否与抗 VEGF 治疗相比降低了 MTF。
比较了接受玻璃体内皮质类固醇治疗的 DME 患者开始皮质类固醇治疗前后的 MTF。使用混合效应线性回归模型来确定 MTF 与最佳矫正视力（BCVA）之间的关联。
在类固醇开始后，平均 12 个月 MTF 明显降低（61.1μm 与 53.5μm， = 0.04， = 105 只眼）。12 个月后的平均 BCVA 与基线相比无显著差异。未发现类固醇后 MTF 与 12 个月 BCVA 之间存在显著相关性。
在先前接受抗 VEGF 治疗的 DME 患者中，皮质类固醇治疗会降低 MTF，而 BCVA 保持稳定。
