Riazi-Esfahani Hamid, Ahmadi Amin, Sadeghi Reza, Mirghorbani Masoud, Ghassemi Fariba, Zarei Mohammad, Khojasteh Hassan, Bayan Nikoo, Faghihi Hooshang, Khalili Pour Elias, Mirshahi Ahmad
Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
J Ophthalmic Vis Res. 2024 Sep 16;19(3):313-323. doi: 10.18502/jovr.v19i3.13622. eCollection 2024 Jul-Sep.
This study aimed to compare macular vascular changes one and three months after treatment with either panretinal photocoagulation (PRP) or intravitreal bevacizumab (IVB).
A total of 62 eyes with very severe non-proliferative diabetic retinopathy or early proliferative diabetic retinopathy without center-involved diabetic macular edema, were included in this retrospective study. Thirty-nine eyes were allocated to the PRP group, while 23 eyes were treated with IVB. Optical coherence tomography angiography (OCTA) was performed to measure foveal avascular zone (FAZ) characteristics as well as the densities of superficial and deep capillary plexuses (SCP and DCP).
In the IVB group, the FAZ area and perimeter expanded at month one but returned to baseline level after three months. In the PRP group, however, the FAZ area and perimeter were rather steady. Changes in the FAZ area were significantly different between the treatment groups at month one ( = 0.02), but not at month three ( = 0.31). There was no significant difference in the change in FAZ circularity index between the two groups at each time point ( = 0.55 and = 0.31). Similarly, changes in SCP density were not statistically significant between the two groups at both time points (all 0.05). A comparison of the two treatment arms based on the mean change in DCP density revealed a significant difference at month one, but not at month three ( = 0.01 and = 0.49, respectively).
Although bevacizumab and PRP have different short-term macular vascular responses, both therapies have the ability to normalize or stabilize vascular measures over time.
本研究旨在比较全视网膜光凝（PRP）或玻璃体腔内注射贝伐单抗（IVB）治疗1个月和3个月后黄斑区血管的变化。
本回顾性研究纳入了62只患有非常严重的非增殖性糖尿病视网膜病变或早期增殖性糖尿病视网膜病变且无累及黄斑中心的糖尿病性黄斑水肿的眼睛。39只眼睛被分配到PRP组，而23只眼睛接受IVB治疗。进行光学相干断层扫描血管造影（OCTA）以测量中心凹无血管区（FAZ）特征以及浅表和深部毛细血管丛（SCP和DCP）的密度。
在IVB组中，FAZ面积和周长在第1个月时扩大，但在3个月后恢复到基线水平。然而，在PRP组中，FAZ面积和周长相当稳定。治疗组之间在第1个月时FAZ面积的变化有显著差异（P = 0.02），但在第3个月时无显著差异（P = 0.31）。两组在每个时间点的FAZ圆形度指数变化均无显著差异（P = 0.55和P = 0.31）。同样，两组在两个时间点的SCP密度变化均无统计学意义（所有P>0.05）。基于DCP密度的平均变化对两个治疗组进行比较，结果显示在第1个月时有显著差异，但在第3个月时无显著差异（分别为P = 0.01和P = 0.49）。
尽管贝伐单抗和PRP有不同的短期黄斑区血管反应，但随着时间的推移，两种治疗方法都有能力使血管测量指标正常化或稳定。
