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接受抗血管内皮生长因子治疗的年轻视网膜静脉阻塞患者的血清学参数

Serologic parameters in young patients with retinal vein occlusion treated with anti-vascular endothelial growth factor.

作者信息

Niu Tong-Tong, Xiao Yun, Lyu Wen-Juan, Zhou Hao

机构信息

Department of Ophthalmology, Xinjiang 474 Hospital, Urumchi 830000, Xinjiang Uygur Autonomous Region, China.

出版信息

Int J Ophthalmol. 2025 Mar 18;18(3):424-434. doi: 10.18240/ijo.2025.03.09. eCollection 2025.

Abstract

AIM

To assess the relationship between serological parameters and the prognosis of young patients with retinal vein occlusion (RVO) after intravitreal conbercept injection (IVC).

METHODS

This study enrolled 100 young patients (≤50 years old) diagnosed with RVO-related macular edema (RVO-ME) who had been undergoing IVC at the 474 Hospital in Xinjiang between January 2022 and October 2023. Patients were categorized into two groups: 70 eyes in the effective group and 30 eyes in the ineffective group. The effective group comprised patients exhibiting a visual acuity improvement of ≥2 lines at the last follow-up, with resolved ME and central macular thickness (CMT) <300 µm. Conversely, the ineffective group included patients with visual acuity improvement of <1 line, persistent ME, and CMT ≥300 µm at the last follow-up. Serological parameters, including white blood cell count, neutrophil count, lymphocyte count, monocyte count, and mean platelet volume were assessed before treatment. The correlation between best-corrected visual acuity (BCVA) and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune inflammation index (SII), and systemic immune response index (SIRI) was analyzed. Additionally, the association between these serological parameters and the efficacy of IVC was explored.

RESULTS

Three months after treatment, the effective group demonstrated a significant improvement in BCVA from 0.82±0.20 to 0.36±0.10, with a concurrent decrease in CMT from 661.28±163.90 to 200.61±82.45 µm (<0.001). Conversely, the ineffective group exhibited minimal changes in BCVA (0.86±0.25 to 0.82±0.14) and CMT (669.84±164.95 to 492.13±138.67 µm, <0.001). The differences in BCVA and CMT between the two groups were statistically significant (<0.001). According to subgroup analysis, in patients with central RVO (CRVO), BCVA improved from 0.82±0.23 to 0.49±0.12 in the effective group and from 0.80±0.18 to 0.76±0.22 in the ineffective group (<0.001). The CMT changes followed a similar pattern. In patients with branch RVO (BRVO), comparable trends in BCVA and CMT changes were observed between the effective and ineffective groups (<0.001). Additionally, the effective group exhibited higher PLR and SII values than the ineffective group (<0.05). Further CRVO and BRVO subgroups analysis exhibited consistent PLR and SII value trends.

CONCLUSION

Compared to other inflammatory factors, elevated PLR and SII levels before treatment are better predictors of outcomes in young RVO-ME patients undergoing IVC treatment.

摘要

目的

评估血清学参数与玻璃体内注射康柏西普(IVC)后年轻视网膜静脉阻塞(RVO)患者预后之间的关系。

方法

本研究纳入了2022年1月至2023年10月期间在新疆474医院接受IVC治疗的100例诊断为RVO相关性黄斑水肿(RVO-ME)的年轻患者(≤50岁)。患者分为两组:有效组70只眼,无效组30只眼。有效组包括在最后一次随访时视力提高≥2行、黄斑水肿消退且中心黄斑厚度(CMT)<300 µm的患者。相反,无效组包括在最后一次随访时视力提高<1行、持续性黄斑水肿且CMT≥300 µm的患者。在治疗前评估血清学参数,包括白细胞计数、中性粒细胞计数、淋巴细胞计数、单核细胞计数和平均血小板体积。分析最佳矫正视力(BCVA)与中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、全身免疫炎症指数(SII)和全身免疫反应指数(SIRI)之间的相关性。此外,探讨了这些血清学参数与IVC疗效之间的关联。

结果

治疗3个月后,有效组的BCVA从0.82±0.20显著提高至0.36±0.10,同时CMT从661.28±163.90降至200.61±82.45 µm(<0.001)。相反,无效组的BCVA(0.86±0.25至0.82±0.14)和CMT(669.84±164.95至492.13±138.67 µm,<0.001)变化极小。两组之间BCVA和CMT的差异具有统计学意义(<0.001)。根据亚组分析,在中心性RVO(CRVO)患者中,有效组的BCVA从0.82±0.23提高至0.49±0.12,无效组从0.80±0.18提高至0.76±0.22(<0.001)。CMT变化遵循类似模式。在分支性RVO(BRVO)患者中,有效组和无效组之间BCVA和CMT变化趋势相似(<0.001)。此外,有效组的PLR和SII值高于无效组(<0.05)。进一步的CRVO和BRVO亚组分析显示PLR和SII值趋势一致。

结论

与其他炎症因子相比,治疗前PLR和SII水平升高是接受IVC治疗的年轻RVO-ME患者预后的更好预测指标。

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