Avastin联合黄斑格栅样光凝治疗DME的视力预后的多因素分析

Multi-factor analysis of the effects on visual acuity prognosis of intravitreal Avastin and macular grid photocoagulation for diabetic macular edema

目的:探讨影响玻璃体腔注射Avastin联合黄斑格栅样光凝治疗糖尿病黄斑水肿(diabetic macular edema,DME)后患者视力的相关因素。方法:回顾性分析Avastin联合黄斑格栅样光凝治疗糖尿病黄斑水肿患者41例41眼。运用SPSS14.0分析患者性别、年龄、病程、治疗前最佳矫正视力(BCVA)、治疗前黄斑中心凹视网膜厚度(CMT)、DME类型、治疗后CMT变化、黄斑中心凹下有无大片硬性渗出与治疗后BCVA之间的相关性。结果:在治疗后1mo时,BCVA与病程、治疗前BCVA、黄斑水肿减轻程度及黄斑中心凹下是否有大片硬性渗出相关(P<0.05)。结论:选择术前视力较好、病程短、黄斑中心凹下无大片硬性渗出的患者经联合治疗后可获得较好的视力。

AlM：To investigate the related factors of effects on best-corrected visual acuity （BCVA） after intravitreal Avastin combined with macular grid photocoagulation（MGP） for diabetic macular edema（DME）. METHODS：A retrospective review of a consecutive series of 41 DME patients（41 eyes） who received intravitreal Avastin combined with MGP. Gender, disease course, the changes of central macular thickness （CMT）, type of DEM, changes of postoperative CMT, massive subfoveal hard exudates and visual acuity 1 month after treatment were recorded. Multi-factor regression analysis of BCVA after the combined treatment was performed with SPSS statistics software. P0.05 was considered statistically significant. RESULTS： The postoperative BCVA was related to the preoperative BCVA, disease course, the changes of CMT and massive subfoveal hard exudates （P0.05）. CONCLUSlON： The better preoperative BCVA is, the better postoperative BCVA would be. Early treatment for the patients with DME would get better postoperative BCVA. Postoperative BCVA is relatively improved in patients with obvious regression of macular edema. Patients with massive submacular hard exudates could hardly be improved in postoperative BCVA.