视网膜静脉阻塞合并黄斑水肿抗VEGF治疗后黄斑中心凹无血管区的变化

The changes in foveal avascular zone area after intravitreal anti-vascular endothelial growth factor injection for macular edema secondary to retinal vein occlusion

目的评价视网膜静脉阻塞(RVO)合并黄斑水肿抗血管内皮生长因子(VEGF)治疗前后黄斑中心凹无血管区(FAZ)面积的变化。方法回顾性病例对照研究。2018年4～6月临床确诊为RVO合并黄斑水肿的44例患者纳入研究,分为治疗组(n=23例,玻璃体腔注射0. 5 mg/0. 05 ml康柏西普)和对照组(不采用任何干预)。对比治疗前后最佳矫正视力(BCVA)以及行相干光断层扫描血管成像(OCTA)检查,软件自动识别及测量治疗前后黄斑中心凹厚度(CMT)和浅层视网膜毛细血管网FAZ面积的变化。结果随访时间为1个月,治疗组BC-VA较治疗前显著提高,且治疗组患者BCVA显著优于对照组,差异有统计学意义(P <0. 05),治疗组CMT较治疗前显著降低,且治疗组患者CMT显著低于对照组,差异有统计学意义(P <0. 05),治疗前后浅层视网膜毛细血管网FAZ面积变化无显著差异(P> 0. 05)。结论单次抗VEGF治疗RVO合并黄斑水肿在短期内平均BCVA和CMT明显好转,并且未加重黄斑缺血。

Objective To evaluate the changes in fovea avascular zone (FAZ) area after the first intravitreal anti-vascular endothelial growth factor(VEGF)injection for macular edema secondary to retinal vein occlusion(RVO).Methods In this retrospective case-control studies, 44 eyes with macular edema secondary to RVO was included from April to July 2018. They were divided into treatment group ( n =23 cases, 0.5mg/0.05ml intravitreal injection of Conbercept) and control group ( n =21 cases, not any treatment). BCVA and OCTA were compared before and after treatment, and central macular thickness (CMT) and superficial retinal capillary network (FAZ) were identified and measured by software.Results The follow-up time was 1 month. BCVA of treatment group patients significantly better than the control group, the difference was statistically significant ( P <0.05), The CMT of the treatment group was significantly lower than the control group, the difference was statistically significant ( P <0.05), before and after treatment of shallow retinal capillary network FAZ area change there was no significant difference ( P >0.05). Conclusions Single Anti-VEGF treatment of RVO induced macular edema significantly improved the average BCVA and CMT in a short period, and did not aggravate macular ischemia.