糖尿病黄斑水肿OCT中高反射灶与视力预后的关系

发布时间：2018-08-25 19:43

【摘要】：目的分析糖尿病黄斑水肿患者相干光断层扫描(OCT)中不同位置的高反射灶是否与视力预后相关,并观察抗VEGF治疗后OCT中高反射灶的变化情况。设计回顾性病例系列。研究对象2013年2月至2016年8月糖尿病黄斑水肿经抗血管内皮生长因子(VEGF)治疗的患者28例。方法所有入选病例在基线及末次访视时,均行最佳矫正视力、眼压、裂隙灯、间接检眼镜、彩色眼底照相、荧光素眼底血管造影及OCT检查。采用Heidelberg Spectralis OCT获得通过中心凹的黄斑区OCT图像,计数所扫范围内97幅B扫描中视网膜各层和玻璃体腔所有高反射灶的数量。平均随访(4.96±1.37)个月。分析不同位置高反射灶数量与视力预后的相关性。主要指标基线及末次随访的最佳矫正视力、中心视网膜厚度、视网膜各层高反射灶的数量、所扫玻璃体腔高反射灶数量与所扫玻璃体腔总面积的比值(RATIO)。结果内层视网膜中高反射灶数量为(156.00±118.76)个,外层视网膜为(3.79±5.25)个,RATIO为0.05±0.06。28眼(100%)均能在内层视网膜见到高反射灶,17眼(60.71%)在外层视网膜可见高反射灶。末次随访视力与基线期外层视网膜中高反射灶的数量呈明显的负相关(r=-0.506,P=0.006),与RATIO也呈负相关(r=0.462,P=0.013),而与内层视网膜中高反射灶的数量不相关(r=-0.163,P=0.408)。经抗VEGF治疗后内层视网膜及外层视网膜中高反射灶的数量均明显减少,而RATIO无明显变化。结论在经抗VEGF治疗的糖尿病黄斑水肿中,外层视网膜高反射灶的数量与视力预后呈明显负相关,而内层视网膜内高反射灶数量则与视力预后不相关。
[Abstract]:Objective to analyze whether the hyperreflex foci in (OCT) of diabetic macular edema patients are related to the prognosis of visual acuity, and to observe the changes of hyperreflex foci in OCT after anti VEGF therapy. Design retrospective case series. Participants 28 patients with diabetic macular edema treated with anti-vascular endothelial growth factor (VEGF) from February 2013 to August 2016. Methods at baseline and at the last visit, all patients were examined with best corrected visual acuity, intraocular pressure, slit lamp, indirect ophthalmoscope, color fundus photography, fundus fluorescein angiography and OCT. The OCT images of macular area passing through the fovea were obtained by Heidelberg Spectralis OCT, and the number of hyperreflex foci in all layers of retina and vitreous cavity in 97 B-scan images were counted. The mean follow-up was (4.96 卤1.37) months. To analyze the correlation between the number of hyperreflex foci in different locations and the prognosis of visual acuity. Main outcome measures: best corrected visual acuity (BCVA), central retinal thickness, number of hyperreflex foci in each layer of the retina, ratio of the number of hyperreflex foci to the total area of the vitreous cavity scanned by (RATIO). Results the number of hyperreflex foci in the inner retina was (156.00 卤118.76) and (3.79 卤5.25) RATIO in the outer retina was 0.05 卤0.06.28 eyes (100%). 17 eyes (60.71%) had hyperreflex foci in the inner retina. At the last follow-up, there was a significant negative correlation between visual acuity and the number of hyperreflex foci in the outer retina in the baseline phase (r = -0.506), a negative correlation with RATIO (r = 0.462), but no correlation between the visual acuity and the number of hyperreflex foci in the inner retina (r = -0.163, P = 0.408). The number of hyperreflex foci in the inner retina and the outer retina decreased significantly after anti-VEGF treatment, but RATIO did not change significantly. Conclusion in diabetic macular edema treated with anti VEGF, the number of hyperreflex foci in the outer retina is negatively correlated with the visual prognosis, but the number of hyperreflex foci in the inner retina is not related to the prognosis of the visual acuity.
【作者单位】：首都医科大学附属北京同仁医院北京同仁医院眼科中心眼科学与视觉科学北京市重点实验室;
【分类号】：R587.2;R774.5

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