玻璃体内注射雷珠单抗对湿性年龄相关性黄斑变性患者脉络膜厚度及睫状后动脉血流的影响

Effects of intravitreal ranibizumab injection on subfoveal choroidal thickness and posterior ciliary artery hemodynamics in patients with wet age-related macular degeneration

目的观察湿性年龄相关性黄斑变性患者经单独玻璃体内注射雷珠单抗治疗后脉络膜厚度及睫状后动脉血流的变化。方法纳入20例(20眼)患者。所有患者治疗前及治疗后1周、4周记录睫状后动脉血流动力学参数,包括收缩期峰值流速、舒张末期血流速度、阻力指数及搏动指数;采用Spectralis OCT的EDI技术,测量中心凹下脉络膜厚度和视网膜中心厚度。比较患者治疗前后不同时间点各指标的差异性。结果治疗前、治疗后1周及治疗后4周视网膜中心厚度分别为(396.47±95.20)μm、(364.33±87.21)μm、(327.93±62.86)μm,治疗前后比较差异均有统计学意义。治疗前、治疗后1周及治疗后4周最佳矫正视力分别为(0.80±0.46)Log MAR、(0.56±0.27)Log MAR、(0.47±0.21)Log MAR,治疗前后比较差异均具有统计学意义。治疗前、治疗后1周及治疗后4周中心凹下脉络膜厚度分别为(256.64±57.11)μm、(251.37±56.76)μm、(248.27±56.22)μm,治疗前后比较差异均具有统计学意义。治疗后1周、4周与治疗前比较睫状后动脉的收缩期峰值流速、舒张末期血流速度、阻力指数及搏动指数差异均无统计学意义。结论湿性年龄相关性黄斑变性患者单独玻璃体内注射雷珠单抗会引起中心凹下脉络膜厚度降低,但不影响睫状后动脉的血流。

Objective To observe the changes of choroidal thickness and posterior ciliary artery（ PC A） hemodynamics in patients who had undergone a single intravitreal ranibizumab injection for wet age-related macular degeneration（ wAMD）. Methods Twenty wAMD patients（ 20 eyes） who had undergone intravitreal 0. 5 mg ranibizumab injection were enrolled in this study. PC A of patients were evaluated by color D oppler sonography. Peak systolic velocity（ PSV）,end-diastolic velocity（ EDV）,resistance index（ RI） and pulsatility index（ PI） values were calculated before injection and 1 week,4 weeks after injection. Enhanced depth imaging on Spectralis optical coherence tomography was used to measure the subfoveal choroidal thickness（ SFCT） and central retinal thickness（ CRT）. The differences of SFCTand posterior ciliary artery hemodynamic parameters were analyzed before injection and 1 week,4 weeks after injection.Results CRTbefore injection and 1 week,4 weeks after injection were（ 396. 47 ± 95. 20）μm,（ 364. 33 ± 87. 21） μm,（ 327. 93 ± 62. 86） μm,respectively,and the differences were significant. The visual acuity before injection and 1 week,4 weeks after injection were（ 0. 80 ± 0. 46）log MAR,（ 0. 56 ± 0. 27） log MAR,（ 0. 47 ± 0. 21） log MAR,respectively,and the differences were significant. SFC Tbefore injection and 1 week,4 weeks after injection were（ 256. 64 ± 57.11） μm,（ 251. 37 ± 56. 76） μm,（ 248. 27 ± 56. 22） μm,respectively,and the differences were significant. C ompared with pre-injection,the values of PSV,ED V,R I and PI at 1 week,4 weeks after injection show ed no statistically significant difference in PC A. Conclusion Intravitreal ranibizumab injection for wAMD cause the decreases of SFC T,but don＇t affect the PC A hemodynamics.