雷珠单抗对视网膜中央静脉阻塞继发黄斑水肿患者黄斑区视网膜血流参数的影响

目的 观察视网膜中央静脉阻塞(CRVO)继发黄斑水肿患者黄斑区视网膜血流参数以及观察雷珠单抗治疗前后黄斑区视网膜血流参数的变化。 方法 前瞻性对照研究。纳入2015年11月至2017年1月在襄阳市中心医院眼科就诊的CRVO继发黄斑水肿的患者33例为CRVO组,同时纳入健康人30例为对照组。所有CRVO继发黄斑水肿患者接受玻璃体腔内雷珠单抗注射治疗。用RTVue-100光学相干断层扫描血流成像技术3 mm×3 mm扫描模式测量研究对象黄斑区视网膜血管密度以及中央凹无血管区域(FAZ)面积。 结果 CRVO组的黄斑区视网膜浅层血管密度与深层血管密度分别为43.03%±5.11%以及47.00%±7.54%,对照组浅层以及深层视网膜血管密度分别为63.23%±5.50%以及61.43%±7.90%,两组之间均差异有统计学意义(P<0.001)。CRVO组FAZ面积为(0.49±0.08) mm²,对照组为(0.28±0.07) mm²,CRVO组FAZ面积明显小于对照组,均差异有统计学意义(P<0.001)。球内注射雷珠单抗后,CRVO组视网膜浅层与深层血管密度以及FAZ面积均未发生明显变化。 结论 相对于健康人,CRVO继发黄斑水肿的视网膜血管密度较低,FAZ面积偏大。CRVO继发黄斑水肿患者接受球内雷珠单抗治疗后,视网膜血管密度以及FAZ面积未见明显变化。

Effect of ranibizumab intravitreal injection on blood flow in eyes with macular edema secondary to central retinal vein occlusion

Objective To measure the foveal avascular zone (FAZ) and macular vessel density in eyes with macular edema secondary to central retinal vein occlusion (CRVO) and to evaluate the changes in FAZ area and the macular vessel density after intravitreal ranibizumab injection for macular edema secondary to retinal vein occlusion. Methods The prospective comparative study involved 33 eyes of 33 patients with macular edema secondary to CRVO and 30 control subjects from November 2015 to January 2017.All patients with macular edema secondary to CRVO received ranibizumab intravitreal injection therapy.The FAZ areas and macular vessel density were evaluated with RTVue-100 optical coherence tomography angiography (OCT-A) by using 3 mm×3 mm images of the macula. Results The mean superficial vessel density and deep vessel density in patients with macular edema secondary to CRVO were 43.03%±5.11% and 47.00%±7.54%,respectively.The mean superficial vessel density and deep vessel density in normal eyes were 63.23%±5.50% and 61.43%±7.90%,respectively.There was a statistically significant difference between the two groups.The mean FAZ area in patients with macular edema secondary to CRVO and control subjects were (0.49±0.08) mm² and (0.28±0.07) mm²,respectively and showed the significant difference (P<0.001).FAZ and vessel density in the superficial and deep were not significantly different before and after intravitreal injection (all P>0.05). Conclusion Compared with normal subjects,patients with macular edema secondary to CRVO had smaller vessel density and larger FAZ area.Macular vessel density and FAZ area remained statistically unchanged after the intravitreal injection of ranibizumab in patients with macular edema secondary to CRVO.