摘要
目的观察息肉样脉络膜血管病变(PCV)患眼玻璃体腔注射抗血管内皮生长因子药物治疗后光相干断层扫描血管成像(OCTA)图像特征,初步探讨其在PCV诊断和治疗后随访中的意义。方法回顾性病例研究。2018年8月至2020年1月于潍坊医学院附属医院眼科检查确诊的PCV患者22例22只眼纳入研究。其中,男性10例10只眼,女性12例12只眼;平均年龄(67.75±9.53)岁。均行最佳矫正视力(BCVA)、OCTA、吲哚青绿血管造影(ICGA)检查。患眼均行玻璃体腔注射10 mg/ml康柏西普0.05 ml(含康柏西普0.5 mg),每一个月1次,连续3个月。采用OCTA仪对黄斑区3 mm×3 mm及6 mm×6 mm范围进行扫描,测量治疗前及治疗后12个月中心凹视网膜厚度(CRT)、异常分支血管(BVN)面积、色素上皮脱离(PED)高度、黄斑中心凹脉络膜厚度(SFCT)。观察OCTA对PCV诊断率,以及BCVA、OCTA各项指标变化。治疗前后BCVA、CRT比较行配对t检验;BVN面积、PED高度、SFCT比较行方差分析。分析患者治疗前后OCTA的影像学特征变化。结果22只眼中,BVN 8只眼;息肉样病灶(polyps)5只眼;BVN合并polyps 5只眼;未发现BVN和polyps 3只眼;小片状血管网结构1只眼,此患眼ICGA表现为结节样强荧光(polyps)。OCTA对PCV的检出率为86.36%(19/22)。治疗后12个月,BVN明显减少或消失16只眼(72.72%,16/22);polyps消退17只眼(77.27%,17/22)。与治疗前比较,治疗后12个月,BCVA提高(t=3.071),CRT下降(t=2.440),差异均有统计学意义(P<0.05);平均BVN面积、PED高度、SFCT均下降,平均BVN面积、PED高度差异有统计学意义(F=2.805、3.916,P<0.05),SFCT差异无统计学意义(F=0.047,P>0.05)。结论OCTA对PCV的检出率为86.36%。PCV抗血管内皮生长因子药物治疗后BVN面积减小、polyps消退;OCTA是PCV诊断和抗VEGF药物治疗后随访时有效手段。
Objective To observe the optical coherence tomography angiography(OCTA)image characteristics of polypoid choroidal vascular disease(PCV)after intravitreal injection of anti-vascular endothelial growth factor drugs,and to discuss its significance in the diagnosis and follow-up of PCV.Methods A retrospective case study.From August 2018 to January 2020,22 eyes of 22 patients with PCV diagnosed in the ophthalmological examination of Affiliated Hospital of Weifang Medical University were included in the study.Among them,there were 10 males with 10 eyes and 12 females with 12 eyes;the average age was 67.75±9.53 years.Best corrected visual acuity(BCVA),OCTA,and indocyanine green angiography(ICGA)were performed.All the affected eyes were injected vitreously with 10 mg/ml Conbercept 0.05 ml(including Conbercept 0.5 mg)once a month for 3 consecutive months.Tthe macular area of 3 mm×3 mm and 6 mm×6 mm with an OCTA instrument was scanned,and the foveal retinal thickness(CRT)was measured,the area of abnormal branch blood vessels(BVN).pigment epithelial detachment before and 12 months after treatment(PED)height,foveal choroid thickness(SFCT)were performed.The diagnosis rate of PCV by OCTA was observed,as well as the changes of various indicators of BCVA and OCTA.Before and after treatment,BCVA and CRT were compared by paired t test;BVN area,PED height,and SFCT were compared by variance analysis.The changes in imaging characteristics of OCTA before and after treatment were analyzed.Results Among the 22 eyes,8 eyes were BVN;5 eyes were polypoid lesions(polyps);5 eyes were BVN combined with polyps;3 eyes were not found with BVN and polyps;1 eye with small vascular network structure,this eye was ICGA Appears as strong nodular fluorescence(polyps).The detection rate of PCV by OCTA was 86.36%(19/22).Twelve months after treatment,BVN was significantly reduced or disappeared in 16 eyes(72.72%,16/22);polyps disappeared in 17 eyes(77.27%,17/22).Compared with before treatment,12 months after treatment,BCVA increased(t=3.071),CRT decreased(t=2.440),the difference was statistically significant(P<0.05);the average BVN area,PED height,and SFCT decreased.The difference in average BVN area and PED height was statistically significant(F=2.805,3.916;P<0.05),and the difference in SFCT was not statistically significant(F=0.047,P>0.05).Conclusions The detection rate of PCV by OCTA is 86.36%.After PCV anti-vascular endothelial growth factor drug treatment,BVN area decrease and polyps subside.OCTA is an effective means for PCV diagnosis and follow-up after anti-VEGF drug treatment.
作者
郭瑜
王淑娜
李立超
杨凯莉
李秀云
Guo Yu;Wang shuna;Li lichao;Yang Kaili;Li Xiuyun(Teaching and Research Office of Ophthalmology,Weifang Medical University,Weifang 261035,China;Department of Ophthalmology,Affiliated Hospital of Weifang Medical University,Weifang 261035,China)
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2021年第6期449-454,共6页
Chinese Journal of Ocular Fundus Diseases
基金
潍坊市科技局课题(2019YX018)
潍坊医学院附属医院博士基金课题(2020BSQD02)。
作者简介
通信作者:李秀云,Email:xiuyun129@163.com。
