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新冠疫情期间视网膜静脉阻塞患者玻璃体内抗VEGF治疗中断的短期和长期影响:黄斑水肿的功能结局及基于人工智能的液体分析

Short and long-term impact of intravitreal anti-VEGF therapy interruption in retinal vein occlusion during the COVID-19 pandemic: functional outcomes and AI-based fluid analysis of macular edema.

作者信息

Moret Emmanuelle, Cattaneo Jennifer, Elwakil Adham, Montesel Andrea, Tommasoni Mattia, Eandi Chiara M

机构信息

Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, Lausanne, Switzerland.

Department of Surgical Science, University of Torino, Torino, Italy.

出版信息

Int J Retina Vitreous. 2025 Aug 5;11(1):92. doi: 10.1186/s40942-025-00717-x.

Abstract

BACKGROUND

The aim of the study is to investigate the short- and long-term effects of delayed intravitreal anti-VEGF injections (IVI) for macular edema (ME) in retinal vein occlusion (RVO) patients during the first wave of the COVID-19 pandemic.

METHODS

This is a retrospective observational study analyzing a cohort of patients followed at the medical retina department of the Jules Gonin Eye Hospital. During the COVID-19 lockdown, treatment for patients with ME secondary to RVO was deferred due to emergency federal dispositions. The impact on best corrected visual acuity (BCVA) and on OCT changes (i.e. central subfield thickness (CST), intraretinal fluid (IRF), and subretinal fluid (SRF)) were assessed at several time points before and after the lockdown over a 2-year period. The OCT parameters were assessed by the mean of an artificial intelligence (AI) software (Discovery, RetinAI).

RESULTS

A total of 64 patients were included in the study. BCVA significantly decreased following a mean treatment delay of 10 weeks. However, BCVA returned to baseline levels after 6 months, with no significant differences observed after 2-years of follow-up. OCT analysis revealed an increase in CST, IRF and SRF following the treatment delay, which decreased and return to pre-lockdown values after 3 months. No significant differences in OCT parameters were observed at the two-year follow-up.

CONCLUSION

The results of our study suggest that delaying IVI for RVO patients during the COVID-19 lockdown resulted in a temporary decline in BCVA and a recurrence of ME. However, these effects were not sustained long term, as both BCVA and ME control returned to baseline levels by 6 months, with no significant changes observed at the two-year follow-up.

摘要

背景

本研究旨在调查在新冠疫情第一波期间,延迟玻璃体内注射抗血管内皮生长因子(IVI)治疗视网膜静脉阻塞(RVO)患者黄斑水肿(ME)的短期和长期效果。

方法

这是一项回顾性观察研究,分析了在朱尔斯·戈宁眼科医院医学视网膜科随访的一组患者。在新冠疫情封锁期间,由于联邦紧急处置措施,RVO继发ME患者的治疗被推迟。在封锁前后的2年期间,在几个时间点评估了对最佳矫正视力(BCVA)和光学相干断层扫描(OCT)变化(即中心子野厚度(CST)、视网膜内液(IRF)和视网膜下液(SRF))的影响。OCT参数由人工智能(AI)软件(Discovery,RetinAI)进行均值评估。

结果

共有64例患者纳入本研究。平均治疗延迟10周后,BCVA显著下降。然而,6个月后BCVA恢复到基线水平,随访2年后未观察到显著差异。OCT分析显示,治疗延迟后CST、IRF和SRF增加,3个月后下降并恢复到封锁前的值。在两年随访中,OCT参数未观察到显著差异。

结论

我们的研究结果表明,在新冠疫情封锁期间延迟RVO患者的IVI治疗导致BCVA暂时下降和ME复发。然而,这些影响并未长期持续,因为BCVA和ME控制在6个月时均恢复到基线水平,在两年随访中未观察到显著变化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4086/12326874/906b9c7ea99d/40942_2025_717_Fig1_HTML.jpg

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