摘要
目的利用光学相干断层扫描血管成像(OCTA)观察玻璃体腔注射雷珠单抗对中心性渗出性脉络膜视网膜病变(CEC)的临床疗效。方法回顾性分析2018年9月1日~2019年10月1日就诊于潍坊医学院附属医院眼科中心的CEC患者18例18眼,所有患者均首次接受抗血管内皮细胞生长因子(VEGF)药物雷珠单抗治疗,治疗前行最佳矫正视力(BCVA)、眼压、裂隙灯显微镜、间接眼底镜、OCTA及FFA和(或)ICGA检查,观察比较治疗前与治疗后1d,15d,1个月时BCVA、黄斑中心凹无血管区(FAZ)面积、黄斑区新生血管面积、黄斑中心凹厚度(CMT)、浅层视网膜毛细血管丛(SCP)及深层视网膜毛细血管丛(DCP)血流密度变化情况。结果①BCVA、CMT、FAZ、新生血管面积:治疗后1d:各指标治疗前后比较,差异均无显著性(P>0.05);治疗后15d:仅CMT及新生血管面积与治疗前比较,差异有显著性(P<0.05);治疗后1个月:BCVA、CMT、新生血管面积与治疗前比较,差异均有显著性(P<0.05),FAZ治疗后各时间点与治疗前比较,差异均无显著性(P>0.05)。②SCP血流密度:治疗后1d:总区域、中心凹、旁中心凹血流密度较治疗前差异均无显著性(P>0.05);治疗后15d:仅中心凹处血流密度较前减少,差异有显著性(P<0.05);治疗后1个月:总区域、中心凹、旁中心凹血流密度较治疗前减少,差异均有显著性(P<0.05);③DCP血流密度:治疗后各时间点中心凹、旁中心凹及总区域的血流密度与治疗前相比差异均无显著性(P>0.05)。结论①OCTA能准确发现CEC患者脉络膜和视网膜毛细血管层血流变化及新生血管情况,对CEC有临床指导意义;②雷珠单抗治疗CEC在短期内效果确切,可提高视力,降低黄斑中心凹厚度,减少新生血管面积。
Objective OCTA was used to observe the clinical effect of intravitreal injection of ranibizumab on central exudative chorioretinopathy.Methods A retrospective analysis was made on 18 patients(18 eyes)with CEC who were treated in the Ophthalmology Center of the Affiliated Hospital of Weifang Medical University from September 1,2018 to October 1,2019.All patients were treated with anti-vascular endothelial growth factor drug ranibizumab for the first time.BCVA,intraocular pressure,slit lamp microscope,indirect ophthalmoscopy,OCTA and FFA,and/or ICGA were all examed before treatment.The changes of BCVA,FAZ area of macular fovea,macular neovascularization area,macular fovea thickness,blood density of superficial and deep retinal capillary plexus were observed before and after treatment.Results①BCVA,CMT,FAZ,neovascularization area:1 day after treatment:there was no significant difference in each index before and after treatment(P>0.05);15 days after treatment:only CMT and neovascularization area were significantly different from those before treatment(P<0.05);1 month aftertreatment:BCVA,CMT,neovascularization area were significantly different from those before treatment(P<0.05).There was no significant difference at each time point after FAZ treatment compared with that before treatment(P>0.05).②SCP blood flow density:1 day after treatment:there was no significant difference in the total area,fovea and paracentral fovea blood flow density(P>0.05);15 days after treatment:only the central fovea blood flow density decreased,the difference was statistically significant(P<0.05);1 month after treatment:the total area,fovea,paracenter blood flow density decreased,which has significant difference(P<0.05).③DCP blood flow density:There was no significant difference in the vascular density of the central fovea(P>0.05),the paracentric fovea and the total area at each time point after treatment as compared with that before treatment.Conclusion①OCTA can accurately detect the pathological changes and neovascularization of choroid and retinal capillary layer in patients with CEC,which has clinical significance for CEC.②Ranibizumab is effective in the treatment of CEC in a short time,which can improve visual acuity,reduce the thickness of macular fovea and reduce the area of neovascularization.
作者
李双双
孙艳
王淑娜
王军梅
邓爱军
LI Shuangshuang;SUN Yan;WANG Shuna;WANG Junmei;DENG Aijun(Department of Ophthalmology,Weifang Medical University,Weifang 261053,China;Ophthalmology Center,the Affiliated Hospital of Weifang Medical University)
出处
《潍坊医学院学报》
2020年第2期92-95,120,共5页
Acta Academiae Medicinae Weifang
作者简介
李双双(1990年-),女,在读硕士研究生。主要研究方向:眼底病;通讯作者:邓爱军,E-mail:dengaijun@hotmail.com。
