糖尿病黄斑水肿对抗VEGF药物治疗的不同反应与糖尿病视网膜病变程度的相关性

Correlat ion between responses to intravitreal injection of anti-VEGF and diabetic retinopathy extent in diabetic macular edema patients

目的:通过观察糖尿病黄斑水肿(diabetic macular edema,DME)患者对于玻璃体腔注射抗VEGF治疗的不同反应和糖尿病视网膜病变(diabetic retinopathy,DR)的不同程度之间的相关性,进一步阐释糖尿病黄伴水肿的发病机制和治疗策略。方法:选择非增生性糖尿病视网膜病变(non proliferative diabetic retinopathy,NPDR)伴发DME的患者27例33眼,增生性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)伴发DME的患者32例34眼。均给予玻璃体腔注射抗VEGF药雷珠单抗,观察两组患者对该药的不同反应,并进行统计学比较。结果:分别把患者治疗3、6mo时的最佳矫正视力(best corrected visual acuity,BCVA)和黄斑中心视网膜厚度(central macular thickness,CMT)和治疗前的BCVA、CMT作比较,NPDR组有统计学差异(P<0.05),PDR组无统计学差异(P>0.05)。NPDR组和PDR组比较,3、6mo时的BCVR和CMT均有统计学差异(P<0.05)。结论:糖尿病视网膜病变的不同程度影响着糖尿病黄斑水肿对抗VEGF治疗的反应。

AIM. To further investigate the etiology and treatment strategies of diabetic macular edema （DME） by studying the correlation between responses to intravitreal injection of Ranibizumab （IVR） and diabetic retinopathy （DR） extent in DME patients. METHODS.. This study comprised 33 eyes of 27 non proliferative diabetic retinopathy （NPDR） patients with DME and 34 eyes of 32 PDR patients with DME, who had been followed for at least 6too after IVR. We compared the responses to the anti-VEGF treatment between the two groups. RESULTS. NPDR patients had strong statistical improvement in best corrected visual acuity（ BCVA） and central macular thickness （CMT） after both 3- month treatment and 6-month treatment（ P〈0.05）, While PDR patients had not （ P〉 0.05）. There were also statistical differences（P〈 0.05） in BCVA and CMT between NPDR group and PDR at a time when the patients had receivedboth 3-month treatment and 6-month treatment. CONCLUSION： Different extents of DR have influence on DME responses to anti-VEGF.