玻璃体内注射雷珠单抗治疗重度非增生型糖尿病视网膜病变伴黄斑水肿后患者脉络膜厚度的变化

发布时间：2019-01-16 03:44

【摘要】：目的观察玻璃体内注射雷珠单抗治疗重度非增生型糖尿病视网膜病变伴黄斑水肿后患者脉络膜厚度的变化情况,明确脉络膜厚度与患者视力之间的相关性。方法选取在我院确诊为重度非增生型糖尿病视网膜病变伴黄斑水肿患者23例(23眼),每月眼内注射1次雷珠单抗并连续接受3次治疗,记录患者治疗前以及治疗后1个月、2个月、3个月黄斑中心凹下脉络膜厚度,同时记录患者黄斑区视网膜神经上皮厚度和最佳矫正视力。分析黄斑中心凹下脉络膜厚度、黄斑区视网膜神经上皮厚度、最佳矫正视力的动态变化情况以及相关性。结果玻璃体内注射雷珠单抗后1个月、2个月、3个月黄斑中心凹下脉络膜厚度和黄斑区视网膜神经上皮厚度均连续下降,前两个月与治疗前相比两指标差异均无统计学意义(均为P0.05),第3个月时与治疗前相比,差异均有统计学意义(P=0.04、0.01)。最佳矫正视力在治疗过程中持续得到改善,前两个月与治疗前相比差异均无统计学意义(均为P0.05),第3个月时与治疗前相比,差异有统计学意义(P=0.04)。治疗前黄斑中心凹下脉络膜厚度与黄斑区视网膜神经上皮厚度之间存在正相关性(R~2=0.94,P=0.00);与治疗前和治疗后3个月最佳矫正视力之间均存在正相关性(R~2=0.93,P=0.00;R~2=0.82,P=0.00)。治疗前黄斑区视网膜神经上皮厚度与治疗后3个月最佳矫正视力之间也存在正相关性(R~2=0.83,P=0.00)。治疗前最佳矫正视力与治疗后3个月最佳矫正视力之间同样存在正相关性(R~2=0.84,P=0.00)。结论黄斑中心凹下脉络膜厚度可以作为评价重度非增生型糖尿病视网膜病变伴黄斑水肿病情变化的有效临床指标,而且可以一定程度上预测抗血管内皮生长因子治疗的效果。
[Abstract]:Objective to observe the changes of choroidal thickness in patients with severe non-proliferative diabetic retinopathy with macular edema after intravitreal injection of Lei Zhu McAb, and to determine the correlation between choroidal thickness and visual acuity. Methods 23 cases (23 eyes) of severe non-proliferative diabetic retinopathy with macular edema were treated by intraocular injection of Lei Zhu McAb once a month and treated continuously for 3 times. The patients were recorded before and 1 month after treatment. The thickness of subfoveal choroid in macular central fovea was recorded at 2 months and 3 months, and the thickness of retinal neuroepithelium and the best corrected visual acuity in macular area were recorded at the same time. To analyze the dynamic changes of subfoveal choroidal thickness, retinal neuroepithelial thickness of macular area, and the best corrected visual acuity (BCVA). Results the thickness of subfoveal choroid and retinal neuroepithelium of macular area decreased 1 month, 2 months and 3 months after intravitreal injection of Lei Zhu McAb. There was no significant difference between the two indexes in the first two months and before treatment (P0.05), and the difference was statistically significant in the third month compared with that before treatment (P0. 04, 0. 01). The best corrected visual acuity was continuously improved in the course of treatment. There was no significant difference between the first two months and before treatment (P0.05), and the difference was statistically significant at the third month compared with that before treatment (P0. 04). There was a positive correlation between the thickness of subfoveal choroid and the thickness of retinal neuroepithelium in macular area before treatment (RP0.00). There was a positive correlation with the best corrected visual acuity (BCVA) before treatment and 3 months after treatment. There was also a positive correlation between the thickness of retinal neuroepithelium in macular area before treatment and the best corrected visual acuity 3 months after treatment (RV = 0.83, P < 0.00). There was also a positive correlation between the best corrected visual acuity before treatment and the best corrected visual acuity 3 months after treatment. Conclusion the thickness of subfoveal choroid can be used as an effective clinical index to evaluate the changes of severe non-proliferative diabetic retinopathy with macular edema and to some extent predict the effect of anti-vascular endothelial growth factor therapy.
【作者单位】：武汉爱尔眼科医院;
【基金】：湖北省卫生计生科研基金资助项目(编号:WJ2015MB258) 爱尔眼科医院集团科研基金项目(编号:AF141D04)~~
【分类号】：R587.2;R774

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