摘要
目的 应用光学相干断层扫描血管成像(OCTA)对比雷珠单抗治疗缺血型和非缺血型视网膜分支静脉阻塞继发黄斑水肿(BRVO-ME)患者的临床疗效和视网膜体积变化的异同。方法 回顾性分析缺血型组34例(34眼)和非缺血型组21例(21眼)的BRVO-ME患者的临床资料,对两组患者均进行玻璃体内注射雷珠单抗治疗,并对治疗前及治疗后1 d、1周、1个月、3个月、6个月患者的最佳矫正视力和黄斑区视网膜体积进行分析。结果 治疗后1 d时最佳矫正视力(logMAR)缺血型组为0.63±0.37,非缺血型组为0.44±0.22,两组相比差异有统计学意义(P=0.017)。视网膜外层、视网膜全层以及视网膜全层Farafovea分区、Perifovea分区的视网膜体积,治疗前缺血型组分别为(6.42±1.90)mm^(3)、(8.75±1.82)mm^(3)、(3.20±0.87)mm^(3)、(5.10±0.89)mm^(3),非缺血型组分别为(5.52±1.57)mm^(3)、(7.83±1.56)mm^(3)、(2.80±0.71)mm^(3)、(4.66±0.77)mm^(3);治疗后1 d缺血型组分别为(4.97±1.18)mm^(3)、(7.46±1.47)mm^(3)、(2.62±0.60)mm^(3)、(4.53±0.80)mm^(3),非缺血型组分别为(4.25±0.48)mm^(3)、(6.58±0.56)mm^(3)、(2.26±0.26)mm^(3)、(4.06±0.40)mm^(3);治疗后1周缺血型组分别为(4.40±0.82)mm^(3)、(6.90±0.85)mm^(3)、(2.38±0.36)mm^(3)、(4.24±0.49)mm^(3),非缺血型组分别为(4.04±0.35)mm^(3)、(6.33±0.49)mm^(3)、(2.15±0.19)mm^(3)、(3.95±0.35)mm^(3),两组相比差异均有统计学意义(均为P<0.05)。视网膜外层和视网膜全层的视网膜体积与基线对比变化量,治疗后1个月时缺血型组分别为(-2.48±2.38)mm^(3)、(-2.54±2.38)mm^(3),非缺血型组分别为(-1.31±1.58)mm^(3)、(-1.38±1.58)mm^(3),两组相比差异均有统计学意义(均为P<0.05)。结论 雷珠单抗治疗缺血型和非缺血型BRVO-ME患者疗效均较好,治疗后短期视力预后非缺血型组较缺血型组患者好,缺血型组患者视网膜体积高于非缺血型组,长期治疗后两组患者视力预后和视网膜体积均无明显差异
Objective To compare the clinical outcomes and retinal volume changes in patients with ischemic and non-ischemic macular edema secondary to branch retinal vein occlusion(BRVO-ME)using optical coherence tomography angiography(OCTA).Methods The clinical data of 34 ischemic BRVO-ME patients(34 eyes,ischemic group)and 21 non-ischemic BRVO-ME patients(21 eyes,non-ischemic group)were retrospectively analyzed.Patients in both groups received intravitreal injections of ranibizumab.The best corrected visual acuity(BCVA)and retinal volume of the macular area were assessed before,1 day,1 week,1 month,3 months and 6 months after the treatment.Results The BCVA(logMAR)at 1 day after the treatment was 0.63±0.37 in the ischemic group and 0.44±0.22 in the non-ischemic group,and the difference was statistically significant(P=0.017).The retinal volumes of the outer retina,the full retina,and the Farafovea and Perifovea subdivisions of the full retina before the treatment were(6.42±1.90)mm^(3),(8.75±1.82)mm^(3),(3.20±0.87)mm^(3) and(5.10±0.89)mm^(3) in the ischemic group and(5.52±1.57)mm^(3),(7.83±1.56)mm^(3),(2.80±0.71)mm^(3),and(4.66±0.77)mm^(3) in the non-ischemic group,respectively;1 day after treatment,they were(4.97±1.18)mm^(3),(7.46±1.47)mm^(3),(2.62±0.60)mm^(3) and(4.53±0.80)mm^(3) in the ischemic group and(4.25±0.48)mm^(3),(6.58±0.56)mm^(3),(2.26±0.26)mm^(3) and(4.06±0.40)mm^(3) in the non-ischemic group,respectively;at 1 week after the treatment,they were(4.40±0.82)mm^(3),(6.90±0.85)mm^(3),(2.38±0.36)mm^(3) and(4.24±0.49)mm^(3) in the ischemic group and(4.04±0.35)mm^(3),(6.33±0.49)mm^(3),(2.15±0.19)mm^(3) and(3.95±0.35)mm^(3) in the non-ischemic group,respectively,and the differences between the two groups were statistically significant(all P<0.05).The amount of retinal volume change from baseline in the outer retina and the full retina was(-2.48±2.38)mm^(3) and(-2.54±2.38)mm^(3) in the ischemic group,and(-1.31±1.58)mm^(3) and(-1.38±1.58)mm^(3) in the non-ischemic group at 1 month after treatm
作者
邢振
王淑娜
孙艳
张宇鹏
邢秀明
杨凯莉
赵君
XING Zhen;WANG Shuna;SUN Yan;ZHANG Yupeng;XING Xiuming;YANG Kaili;ZHAO Jun(Department of Ophthalmology,Affiliated Hospital of Weifang Medical University,School of Clinical Medicine,Weifang Medical University,Weifang 261000,Shandong Province,China;Department of Ophthalmology,Affiliated Hospital of Weifang Medical University,Weifang 261000,Shandong Province,China)
出处
《眼科新进展》
CAS
北大核心
2024年第3期217-222,共6页
Recent Advances in Ophthalmology
基金
潍坊医学院附属医院博士启动基金(编号:2020BSQD09)
潍坊医学院附属医院临床研究项目(编号:2020wyfylcyj06)。
