抗VEGF治疗CNV前后OCT黄斑区相关参数的动态分析

目的动态分析脉络膜新生血管(Choroindal neovascularization,CNV)患眼玻璃体腔抗血管内皮生长因子(vascular endothelial growth factor,VEGF)治疗前后谱域光学相干断层扫描成像(Spectral-Domain Optical CoherenceTomography,SD-OCT)黄斑区相关参数。方法采用自身前后对照系列病例观察研究设计。纳入2019年6月-2019年11月确诊的脉络膜新生血管患者9例10眼,其中男5例,女4例,平均年龄(66±11.8)岁。所有患者均行玻璃体腔注射抗VEGF药物,1次/月,共3次。分别于注射前及注射3周后行SD-OCT扫描,观察黄斑中心凹厚度、黄斑区病灶处视网膜厚度的变化及治疗前后最佳矫正视力。结果确诊为CNV的9例患者(10只患眼),所有患眼基线数据:黄斑中心凹厚度为:509.40±342.047μm,黄斑区病灶处视网膜厚度为:565.90±298.834μm,基础最佳矫正视力为:1.14±0.62;治疗后1、2、3个月后黄斑中心凹厚度分别为:269.40±68.008μm、263.10±85.966μm、48、214.00±147.505μm,黄斑区病灶处视网膜厚度分别为:311.10±74.652μm、307.90±100.865μm、347.00±102.189μm,最佳矫正视力分别为:0.97±0.65、0.89±0.68、0.89±0.68。1个月与基线比较黄斑中心凹视网膜厚度无显著性差异(P=0.052>0.05),2、3个月与基线分别比较黄斑中心凹视网膜厚度有显著性差异(P分别=0.042、0.045<0.05);1、2个月与基线分别比较黄斑区视网膜厚度有显著性差异(P=0.037、0.031<0.05),3个月与基线分别比较病灶处视网膜厚度无显著性差异(P=0.061>0.05);1、2、3个月与基线分别比较最佳矫正视力均有显著差异(P=0.014、0.025、0.025<0.05)。结论CNV病眼抗VEGF治疗后,较基线形态结构与视力均显著性改善。SD-OCT属于无创检查,可重复性高且精准,对黄斑部疾病的治疗具有良好的动态评估价值。

Dynamic Analysis of Correlation Parameters of OCT Macular Area Before and After Anti-VEGF Treatment of CNV

Objective To analyze the parameters of OCT macula before and after anti VEGF treatment in vitreous cavity of CNV patients.Methods A series of case study design was used.From June 2019 to November 2019,9 cases(10 eyes)of choroidal neovascularization were included,including 5 males and 4 females,with an average age of(66±11.8)years.All patients received intravitreal injection of anti-VEGF drugs once a month,three times in total.SD-OCT was performed before and three weeks after injection to observe the thickness of fovea,the retinal thickness of macular focus and the best corrected visual acuity before and after treatment.Results In 9 patients(10 eyes)with CNV,the baseline data of all eyes were:the thickness of fovea was 509.40±342.047μm,the retinal thickness of macular focus was 565.90±298.834μm,the best corrected visual acuity was 1.14±0.62,;The thickness of fovea of macula at 1,2 and 3 months after treatment was as follows:269.40±68.008μm、263.10±85.966μm、48、214.00±147.505μm,The retinal thickness of macular focus was 311.10±74.652μm,307.90±100.865μm and 347.00±102.189μm,respectively.The best corrected visual acuity was 0.97±0.65,0.89±0.68 and 0.89±0.68,respectively.There was no significant difference in fovea retina thickness between 1 month and baseline(P=0.052>0.05).There was significant difference in fovea retina thickness between 2 and 3 months and baseline(P=0.042,0.045<0.05).There was significant difference in the retinal thickness of macular focus between 1 and 2 months and baseline(P=0.037,0.031<0.05).There was no significant difference in the retinal thickness of macular focus between 3 months and baseline(P=0.061>0.05);there was significant difference in the best corrected visual acuity(P=0.014,0.025,0.025<0.05)between 1,2,3 months and baseline.Conclusions After anti VEGF treatment,the morphology and visual acuity of CNV patients were significantly improved.SD-OCT is a non-invasive examination with high repeatability and accuracy.It has a good dynamic evaluation value for the treatment of macular diseases.