雷珠单抗对糖尿病黄斑水肿患者黄斑区视网膜血管密度及形态的影响

Effect of Rainbizumab on retinal vascular density and morphology in patients with diabetic macular edema

目的:应用光学相干断层扫描血管成像(OCTA)观察糖尿病黄斑水肿(DME)患眼经玻璃体腔注射雷珠单抗治疗后短期内黄斑区血管密度及血管形态的变化。方法:收集2019-03/05我院门诊确诊为DME的患者45例52眼,所有患眼均接受玻璃体腔注射雷珠单抗治疗,治疗前和治疗后1wk均行OCTA黄斑区视网膜3mm×3mm范围模式扫描,获得黄斑区浅层毛细血管丛(SCP)血管密度、深层毛细血管丛(DCP)血管密度、微血管瘤个数及中心凹无血管区(FAZ)面积、周长及非圆度指数。结果:SCP血管密度治疗前后无差异(t=1.635,P=0.10);治疗后DCP血管密度(46.59%±4.91%)较治疗前(42.47%±4.16%)增加(t=1.014,P=0.02)。治疗后SCP微血管瘤个数(2.92±0.42个)较治疗前(3.21±0.31个)变化无差异(t=1.623,P=0.21);治疗后DCP微血管瘤个数(6.10±0.67个)较治疗前(8.21±0.41个)减少(t=1.124,P=0.01)。治疗后FAZ面积较治疗前略扩大,FAZ周长略增加,且非圆度指数稍降低,但三者变化均无差异(P>0.05)。结论:玻璃体腔注射雷珠单抗治疗DME患眼后短期内深层毛细血管丛血供增加,且微血管瘤数减少,而浅层毛细血管丛血供及微血管瘤数无明显改变;同时,治疗后短期内FAZ形态(面积、周长及非圆度指数)尚无显著临床意义。

·AIM:To observe vascular density and foveal avascular zone(FAZ) in macular area for diabetic macular edema(DME) with optical coherence tomography angiography(OCTA) when before and after intravitreal injection of rainbizumab.·METHODS:For the 45 DME patients(52 eyes) whose diagnosis were confirmed by ophthalmic clinical examination,their sick eyes were examined by OCTA with macular area 3 x3 mm scanning range model when before and 1 wk after intravitreal injection of rainbizumab,and obtain vascular density of superficial capillary plexus(SCP),deep capillary plexus(DCP),and the number of microaneurysm and the area,perimeter and the roundness index in FAZ,and do block matching t-test.·RESULTS:There was no statistical difference for the vascular density of SCP before and after treatment(t=1.635,P=0.10).Vascular density(46.59%±4.91%) of DCP after treatment were more than before treatment(42.47%±4.16%),and it was statistically significant difference(t=1.014,P=0.02).There was no statistical difference for the number of microaneurysm in SCP when before and after treatment(t=1.623,P=0.21);But the number of microaneurysm(6.10±0.67) in DCP after treatment decreased obviously than before treatment(8.21±0.41),and the difference was statistically significant(t=1.124,P=0.01).The area and perimeter of FAZ after treatment increased than before treatment,but there was no statistical difference(P> 0.05);The roundness index of FAZ after treatment was lower than before treatment,and there was also no statistical difference(P>0.05).·CONCLUSION:The capillary circulation in DCP increased in short term for sick eyes of DME after intravitreal injection of rainbizumab,and the number of microaneurysm in DCP reduced,but the change in SCP is not obvious.At the same time,the area,perimeter and the roundness index of FAZ had no significant meaning of clinical observation for DME with injection of rainbizumab.