视网膜深层血流密度对康柏西普治疗糖尿病性黄斑水肿预后的影响:基于OCTA的评价

目的 研究糖尿病性黄斑水肿(DME)患者视网膜深层毛细血管丛(DCP)的血流密度(VD)与康柏西普治疗预后的关系.方法 回顾性分析2020年1月至2021年7月就诊于潍坊医学院附属医院眼科中心的46例非增生型糖尿病视网膜病变(NPDR)期DME患者(DME组)和同期37例无DME的NPDR患者(对照组)资料.DME组患...

Effect of vessel density in retinal deep capillary plexus on the prognosis of diabetic macular edema treated with Conbercept based on optical coherence tomography angiography

Objective　To investigate the correlation between the vessel density (VD) in retinal deep capillary plexus (DCP) and the prognosis of patients with diabetic macular edema (DME) treated with Conbercept. Methods　This was a retrospective study. A total of 46 DME patients with non-proliferative diabetic retinopathy (NPDR) were selected into the DME group, and 37 NPDR patients without DME were selected into the control group. Patients in the DME group were subdivided into the effective group (>50 μm) and ineffective group (≤50 μm) according to the reduction of central retinal thickness (CRT) after three consecutive intravitreal injections of Conbercept. The vessel density in superficial capillary plexus (SCP-VD), vessel density in deep capillary plexus (DCP-VD), CRT, foveal avascular zone (FAZ), VD in a 300-μm-wide region around the FAZ (FD300) and other parameters were measured by optical coherence tomography angiography (OCTA) before, 1 month and 3 months after treatment with Conbercept, and their correlations were analyzed.Results　Compared with the control group, the global, foveal and parafoveal SCP-VD and DCP-VD in the DME group were significantly lower (all P<0.05). Except CRT, OCTA parameters in the DME group at 1 month and 3 months after treatment had no significant difference compared with those before treatment (all P>0.05). The BCVA (logMAR) in the DME group was 0.38±0.28 at 1 month after treatment and 0.37±0.29 at 3 months after treatment, significantly better than that before treatment (0.54±0.39) (both P<0.05). The CRT in the DME group was (327.457±73.684)μm at 1 month after treatment and (304.761±58.537)μm at 3 months after treatment, significantly lower than that before treatment ［(380.065±82.685)μm］ (both P<0.05). The foveal DCP-VD in the effective group ［(36.258±13.187) %］ was higher than that in the ineffective group ［(28.564±8.855) %］ (P=0.024), while other OCTA parameters (FAZ, FD300, global SCP-VD, foveal and parafoveal SCP-VD, global and parafoveal DCP-VD, CRT) had no significant difference between the two groups (all P>0.05). The preoperative foveal DCP-VD was positively correlated with the CRT decrease at 3 months after treatment (P=0.040). The global and parafoveal DCP-VD at baseline were positively correlated with the BCVA recovery at 3 months after treatment (P=0.033, 0.036). There was no correlation between the rest parameters (all P>0.05).Conclusion　DCP-VD is closely related to the development of macular edema in DME patients. It may be used as an indicator to predict the prognosis of anti-vascular endothelial growth factor therapy in DME patients.