抗VEGF治疗糖尿病性黄斑水肿短期内黄斑区视网膜厚度光感受器层连续性及血流密度变化

目的 探讨抗血管内皮生长因子（VEGF）治疗糖尿病性黄斑水肿（DME）患者短期内黄斑区视网膜厚度、光感受器层连续性及血流密度的变化。方法 收集2019年1～11月在安徽医科大学第一附属医院眼科就诊的23例（30眼） DME且未治疗的患者，其中，11例（17眼）重度非增殖期（NPDR）患者作为重度NPDR组，12例（13眼）增殖期糖尿病视网膜（PDR）患者作为PDR组。抗VEGF治疗前及治疗后2周行光学相干断层扫描血管成像（OCTA）检查，比较两组患者黄斑区视网膜厚度、光感受器层连续性及血流密度变化。结果 抗VEGF治疗后，两组患者黄斑中心凹子区厚度（FRT）、旁中心凹视网膜厚度（PRT）较治疗前均降低，差异有统计学意义（P<0.05）。两组患者治疗前后FRT、PRT及其差值比较，差异无统计学意义（P>0.05）。治疗前，两组患者内节/外节（IS/OS）连续率比较，差异无统计学意义（P>0.05），治疗后，重度NPDR组IS/OS连续率高于PDR组，差异有统计学意义（P<0.05）。两组患者治疗前后血流密度及其差值比较，差异无统计学意义（P>0.05）。结论 DME患者行抗VEGF治疗后，短期内FRT、PRT降低，并且未加重黄斑区视网膜缺血。

Changes of retinal thickness, photoreceptor layer continuity and blood density in macular region in short term after anti-VEGF treatment for diabetic macular edema

Objective To explore the changes of retinal thickness, photoreceptor layer continuity and blood flow density in diabetic macular edema (DME) treated by anti vascular endothelial growth factor (VEGF) in a short period of time. Methods Twenty-three cases (30 eyes) DME patients with treatment were collected in the First Affiliated Hospital of Anhui Medical Universityfrom January to November 2019. Among them, 11 cases (17 eyes) with severe non proliferative diabetic retina (NPDR) were taken as the severe NPDR group and 12 cases (13 eyes) with proliferative diabetic retina (PDR) as the PDR group. Before and after two weeks of anti-VEGF treatment, optical coherence tomography angiography (OCTA) was performed to compare the changes of macular retinal thickness, photoreceptor cell layer continuity, and blood flow density in two groups of patients. Results After anti-VEGF treatment, the foveal retinal thickness (FRT) and parafoveal retinal thickness (PRT) of two groups were lower than those before treatment, and the difference was statistically significant (P<0.05). There was no significant difference in FRT and PRT between the two groups before and after treatment. There was no statistically significant difference of different value in FRT and PRT between the two groups before and after treatment (P>0.05). There was no significant difference in IS/OS continuous rate between the two groups before treatment (P>0.05). The IS/OS continuous rate in severe NPDR group was higher than that in PDR group after treatment, and the difference was statistically significant (P<0.05). Compared with that before treatment, there was no statistically significant difference in blood flow density after treatment (P>0.05). There was no significant difference in blood flow density between the two groups before and after treatment (P>0.05).There was no difference indifferent value in blood flow density between the two groups before and after treatment (P>0.05). Conclusions After anti-VEGF treatment of DME patients, FRT and PRT are reduced in the short term, and retinal ischemia in the macular area is not aggravated.