抗血管内皮生长因子治疗对黄斑水肿患者脉络膜厚度的影响

目的 利用相干光断层扫描加强深度扫描模式（enhanced depth imaging-optical coherence tomography，EDI-OCT）评估玻璃体注射抗血管内皮生长因子（vascular endothelial growth factor, VEGF）药物治疗因糖尿病视网膜病变引起的黄斑水肿（diabetic macular edema, DME）和视网膜静脉阻塞继发的黄斑水肿（retinal vein occlusion-macular edema, RVO-ME）后黄斑中心凹下脉络膜厚度（subfoveal choroidal thickness，SFCT）的变化。设计 回顾性病例系列。研究对象 选取 2014年12月至2018年11月在江南大学附属医院眼科接受玻璃体抗VEGF药物注射术的DME者13眼和RVO-ME者15眼。方法 采用EDI-OCT测量术前和术后1、3、6个月的SFCT，评估玻璃体注射抗VEGF药物治疗DME与RVO-ME后SFCT的变化。主要指标 SFCT。结果 DME组术后1、3、6个月的SFCT值分别为（224.85±50.03）μm、（215.62±47.70）μm、（207.54±46.85）μm，均较术前（244.54±53.62）μm]减小（P=0.0004，0.0002，0.0001）；术后3、6个月的SFCT值较术后1个月减小（P=0.003，0.001）；术后6个月的SFCT值较术后3个月减小（P=0.026）。RVO-ME组术后1、3、6个月的SFCT值分别为（260.67±42.29）μm、（254.33±40.54）μm、（239.73±37.08）μm均较术前（288.13±49.26）μm]减小（P=0.0003，0.0002，0.0002）；术后3个月的SFCT值较术后1个月减小（P=0.599）；术后6个月的SFCT值较术后1、3个月减小（P=0.0002，0.0003）。结论 玻璃体注射抗VEGF药物治疗DME与RVO-ME后SFCT明显减小，动态监测SFCT值对发现病情变化有一定的参考价值。

Changes of choroidal thickness in the treatment of macular edema with anti-vascular endothelial growth factor

Objective To evaluate the changes of subfoveal choroidal thickness after intravitreal injection of anti-vascular endovascular growth factor (VEGF) drugs for macular edema caused by diabetic retinopathy (DME) and macular edema secondary to retinal vein occlusion (RVO-ME) using optical coherence tomography enhanced depth scanning mode (EDI-OCT). Design Retrospective case series. Participants Thirteen eyes with DME and fifteen eyes with RVO-ME who underwent intravitreal anti-VEGF drug injection from December 2014 to November 2018 were selected. Methods The subfoveal choroidal thickness (SFCT) was measured by EDI-OCT before and 1, 3 and 6 months after operation to evaluate the changes of SFCT after intravitreal injection of anti-VEGF drugs for DME and RVO-ME. Main Outcome Measure SFCT. Results The value of SFCT in DME group 1, 3 and 6 months after operation was (224.85±50.03)μm, (215.62±47.70)μm, (207.54±46.85)μm respectively, and was lower than that before operation (P=0.0004, 0.0002, 0.0001); SFCT decreased in 3 and 6 months after operation compared with 1 month after operation (P=0.003, 0.001); SFCT decreased in 6 months after operation compared with 3 months after operation (P=0.026). The value of SFCT in RVO-ME group 1, 3 and 6 months after operation was (260.67±42.29)μm, (254.33±40.54)μm, (239.73±37.08)μm respectively, and was lower than that before operation (P=0.0003, 0.0002, 0.0002); SFCT decreased in 3 months after operation compared with 1 month after operation (P=0.599); SFCT decreased in 6 months after operation compared with 1, 3 months after operation (P=0.0002，0.0003). Conclusion SFCT decreased significantly after intravitreal injection of anti-VEGF drugs for DME and RVO-ME. Dynamic monitoring of SFCT values may be helpful in detecting the changes of the disease.