| 糖尿病黄斑水肿OCT中高反射灶与视力预后的关系 |
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| 引用本文： | 莫宾 周海英 焦璇 张风. 糖尿病黄斑水肿OCT中高反射灶与视力预后的关系[J]. 眼科, 2017, 26(3): 174. DOI: 10.13281/j.cnki.issn.1004-4469.2017.03.007 |
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| 作者姓名： | 莫宾 周海英 焦璇 张风 |
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| 作者单位： | 1000730.首都医科大学附属北京同仁医院 北京同仁医院眼科中心 眼科学与视觉科学北京市重点实验室 |
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| 摘 要： | 目的 分析糖尿病黄斑水肿患者相干光断层扫描（OCT）中不同位置的高反射灶是否与视力预后相关，并观察抗VEGF治疗后OCT中高反射灶的变化情况。设计 回顾性病例系列。研究对象 2013年2月至2016年8月糖尿病黄斑水肿经抗血管内皮生长因子（VEGF）治疗的患者28例。方法 所有入选病例在基线及末次访视时，均行最佳矫正视力、眼压、裂隙灯、间接检眼镜、彩色眼底照相、荧光素眼底血管造影及OCT检查。采用Heidelberg Spectralis OCT获得通过中心凹的黄斑区OCT图像，计数所扫范围内97幅B扫描中视网膜各层和玻璃体腔所有高反射灶的数量。平均随访（4.96±1.37）个月。分析不同位置高反射灶数量与视力预后的相关性。主要指标 基线及末次随访的最佳矫正视力、中心视网膜厚度、视网膜各层高反射灶的数量、所扫玻璃体腔高反射灶数量与所扫玻璃体腔总面积的比值（RATIO）。结果 内层视网膜中高反射灶数量为（156.00±118.76）个，外层视网膜为（3.79±5.25）个，RATIO为0.05±0.06。28眼（100%）均能在内层视网膜见到高反射灶，17眼（60.71%）在外层视网膜可见高反射灶。末次随访视力与基线期外层视网膜中高反射灶的数量呈明显的负相关（r=-0.506, P=0.006），与RATIO也呈负相关（r=0.462, P=0.013），而与内层视网膜中高反射灶的数量不相关（r=-0.163, P=0.408）。经抗VEGF治疗后内层视网膜及外层视网膜中高反射灶的数量均明显减少，而RATIO无明显变化。结论 在经抗VEGF治疗的糖尿病黄斑水肿中，外层视网膜高反射灶的数量与视力预后呈明显负相关，而内层视网膜内高反射灶数量则与视力预后不相关。
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| 关 键 词： | 糖尿病性黄斑水肿 相干光断层扫描 高反射灶 抗血管内皮生长因子 |
| 收稿时间： | 2016-06-15 |
Relationship of hyperreflective foci with visual outcome in diabetic macular edema |
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| MO Bin,ZHOU Hai-ying,JIAO Xuan,ZHANG Feng. Relationship of hyperreflective foci with visual outcome in diabetic macular edema[J]. Ophthalmology in China, 2017, 26(3): 174. DOI: 10.13281/j.cnki.issn.1004-4469.2017.03.007 |
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| Authors: | MO Bin ZHOU Hai-ying JIAO Xuan ZHANG Feng |
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| Affiliation: | Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China |
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| Abstract: | Objective To explore if the numbers of the hyperreflective foci (HF) is relevant to visual outcome of diabetic macular edema (DME), and to observe the changes of HF number after anti-vascular endothelial growth factor (VEGF) treatment. Design Retrospective case series. Participants We reviewed 28 eyes of 28 patients with DME, who were treated with anti-VEGF at Beijing Tongren Eye Center from February 2013 and August 2016. Methods All patients underwent best-corrected visual acuity (BCVA) measurement, slit-lamp examination, spectral domain optical coherence tomography (SD-OCT) at baseline and at final time of the follow-up. Numbers of HF were counted based on different locations including the inner retinal layer, the outer retinal layer and the vitreous cavity. Meanwhile, the areas for each vitreous cavity had to be measured. Then, the ratio of HF numbers to the total areas of vitreous cavity (RATIO) can be calculated. The correlation of the HF numbers in different locations with final BCVA was analyzed. The changes of HF number after anti-VEGF treatment were analyzed as well. Main Outcome Measures The baseline and final BCVA, central retinal thickness (CRT), the HF number in retinal layer, RATIO. Results On SD-OCT images, HF could be located in each retinal layers, as well as in vitreous cavity, but mainly located around external plexiform layer (OPL) in DME. The mean HF number in the inner retinal layer was 156.00±118.76; in the outer retinal layer it was 3.57±4.08; RATIO was 0.05±0.06. HF could be seen in the outer retinal layers among 17 eyes (62.5%), while it was visible in the inner retinal layers for all 28 eyes (100%). BCVA was negatively associated with the baseline numbers of HF in the outer retinal layers (r=-0.506, P=0.006), as well as the RATIO (r=0.462, P=0.013). However, it was not related to the baseline numbers of HF in the inner retinal layers (r=-0.163, P=0.408). The average number of HF reduced significantly in the outer and inner retinal layer, while there was not apparent change for the RATIO after anti-VEGF treatment. Conclusion HF in the outer retinal layer is obviously negatively associated with the final BCVA in patients with DME after anti-VEGF treatment. However, HF in the inner retinal layer is not associated with final BCVA. |
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| Keywords: | diabetic macular edema optical coherence tomography hyperreflective foci anti-VEGF |
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