抗血管内皮生发因子治疗后湿性AMD患者的OCT特征与视力相关性分析

目的 评价湿性年龄相关性黄斑变性(AMD)患者抗血管内皮生长因子(VEGF)治疗后术眼OCT参数与视力之间的相关性.方法 32例32只眼湿性AMD患者接受抗VEGF治疗后5-6月,记录患者最佳矫正视力,同一天进行频域OCT扫描,对黄斑中心凹厚度(FT),黄斑中心区厚度(CST),黄斑区容积(CV),黄斑区平均厚度(CAT),视网膜下液(SRF),视网膜内液(IRF),脉络膜新生血管膜厚度(CN-VMT)等参数进行分析,并根据成像质量进行手动校正,探讨术眼最佳矫正视力与OCT各参数之间的关系.结果 对32例患者的结果分析显示,在CST>210um的患者中,术眼最佳矫正视力(LogMar视力)与校正前后的FT、CV及CAT均无相关性;与校正前后的CST有相关性,相关系数分别为r=0.396,P=0.041;r=0.447,P=0.019,校正后的相关性更强.有视网膜内液组和无视网膜内液组的LogMar视力分别为1.14±0.54和0.64.4±0.49,两组差异有统计学意义(t=2.66 P=0.012). CNV显著组和CNV不显著组的LogMar视力分别0.98 4±0.61,0.57 4±0.34,两组差异有统计学意义(t=2.205 P=0.035).结论 湿性AMD患者抗VEGF治疗后最佳矫正视力(LogMar视力)与校正后的中心区厚度呈正相关.手动校正中心凹位置对正确判断AMD患者抗VEGF治疗的效果十分必要.

Correlation between macular structure and visual outcome following anti-VEGF therapy in wet AMD: a spectral domain optical coherence tomography study

Objective To evaluate the macular structure following anti-VEGF therapy in wet AMD patients and to study the correlation of structural findings with visual acuity outcomes, using spectral domain optical coherence tomography (SD-OCT). Methods Thirty-two cases (32 eyes) with wet AMD after anti-VEGF therapy were included in the study.Ophthalmic examination included best-corrected visual acuity (BCVA), dilated fundus examination and OCT imaging 5-6 months after anti-VEGF therapy.Macular thickness and volume were calculated for morphologic parameters of interest including fovea thickness (FT), central subfield thickness (CST), cube volume (CV), cube average thickness (CAT), subretinal fluid (SRF), intraretinal fluid (IRF), CNV membrane thickness (CNVMT) before and after manually identification of fovea.The correlation between BCVA and OCT parameters were investigated.Results Increased CST was correlated with decreased visual acuity (r =0.447, P=0.019), both pre- and post- manually correction.The association was stronger after manually correction if compared with that before correction.No statistically significant association was detected between BCVA and FT, CA and CAT pre- and post-correction.Decreased visual acuity was also correlated with the presence of the IRF and thicker CNV membrane in the macular region.Con- clusions The manually-corrected CST is strongly correlated with BCVA after anti-VEGF therapy in wet AMD patients. Because of the poor visual function and central fixation in these patients due to the complex macular lesions, manually correction of fovea in OCT analysis is definitely necessary in AMD patients.