Department of Ophthalmology, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, China.
Hunan Clinical Research Center of Ophthalmic Disease, Changsha, China.
BMC Ophthalmol. 2024 Aug 20;24(1):354. doi: 10.1186/s12886-024-03619-y.
The study was designed to investigate microvascular and morphological changes in retinal vein occlusion (RVO) using multimodal imaging after intravitreal ranibizumab (IVR) with or without triamcinolone acetonide (IVTA) injections.
This was a retrospective and observational study. Fifty patients (52 eyes) diagnosed with RVO were enrolled. Best corrected visual acuity (BCVA), ophthalmoscopy, fundus fluorescein angiography (FFA), spectral domain optical coherence tomography (SDOCT), and optical coherence tomography angiography (OCTA) were employed sequentially both before treatment and at the last visit after treatment.
The mean logMAR VAs in BRVO eyes decreased significantly after treatment (P = 0.029). OCTA showed there was a significant difference in foveal avascular zone (FAZ) in BRVO eyes (P = 0.024), superificial foveal vessel density in both CRVO (P = 0.0004) and BRVO eyes (P = 0.02155). OCT showed the foveal thickness had significant differences after treatment in both CRVO (P < 0.0001) and BRVO eyes (P = 0.0001). BCVA was associated most commonly with ellipsoid zone integrity (P = 0.022). The BCVA in eyes treated with IVR and IVTA was significantly decreased compared with IVR only in BRVO group (P = 0.021). However, the combination of IVR + IVTA significantly improved intraocular pressure (IOP) compared with IVR only in BRVO group (P = 0.037).
Both IVR and IVR + IVTA can significantly improve the central vision, macular structure, and functions in BRVO group. Simultaneous IVR with IVTA can significantly increase BCVA compared with IVR only in BRVO group.
本研究旨在通过玻璃体内注射雷珠单抗（IVR）联合或不联合曲安奈德（IVTA）治疗后，利用多模态成像技术观察视网膜静脉阻塞（RVO）的微血管和形态学变化。
这是一项回顾性观察研究。共纳入 50 例（52 只眼）RVO 患者。分别在治疗前和治疗后最后一次就诊时采用最佳矫正视力（BCVA）、眼底镜、眼底荧光素血管造影（FFA）、谱域光学相干断层扫描（SD-OCT）和光相干断层扫描血管造影（OCTA）对患者进行检查。
BRVO 眼的平均对数最小分辨角对数视力（logMAR VA）在治疗后显著提高（P = 0.029）。OCTA 显示 BRVO 眼的中心凹无血管区（FAZ）有显著差异（P = 0.024），CRVO 和 BRVO 眼的浅层黄斑中心凹血管密度（P = 0.0004 和 P = 0.02155）有显著差异。OCT 显示 CRVO（P < 0.0001）和 BRVO 眼（P = 0.0001）治疗后黄斑中心凹厚度有显著差异。BCVA 与椭圆体带完整性相关性最高（P = 0.022）。BRVO 组 IVR 联合 IVTA 治疗后 BCVA 明显低于 IVR 单药治疗组（P = 0.021）。然而，BRVO 组 IVR 联合 IVTA 治疗较 IVR 单药治疗组眼压（IOP）显著降低（P = 0.037）。
IVR 和 IVR 联合 IVTA 均可显著改善 BRVO 患者的中心视力、黄斑结构和功能。BRVO 组 IVR 联合 IVTA 治疗较 IVR 单药治疗组可显著提高 BCVA。
