玻璃体腔抗VEGF治疗对糖尿病性黄斑水肿在OCT不同分型下的疗效研究

Effect of intravitreal anti-VEGF therapy for different patterns of optical coherence tomography of diabetic macular edema

目的探究玻璃体腔注射抗血管内皮生长因子(VEGF)治疗糖尿病性黄斑水肿在相干光层析成像术(OCT)不同分型下的疗效。方法回顾性研究2018年4月至2020年4月,我院采用玻璃体腔抗VEGF治疗的符合欧洲视网膜专家协会(EURETINA)诊断标准的糖尿病黄斑水肿(DME)患者149例159只眼。依据光学相干断层扫描(OCT)将其分弥漫性黄斑水肿(DRT)组(75例)、囊样黄斑水肿(CME)组(53例)、浆液性视网膜脱离(SRD)组(31例),比较抗VEGF治疗不同分型DME的临床有效率、最佳矫正视力(BCVA)、黄斑中心凹厚度(CMT)\不良反应等差异。结果DRT组、CME组的有效率显著高于SRD组(P<0.05);DRT组与CME组有效率无显著的统计学差异(P>0.05);DRT组、CME组、SRD组治疗后相对于治疗前的CMT显著降低(P<0.05),BCVA显著增高(P<0.05);治疗后的组间比较显示,DRT组、CME组的CMT显著低于SRD组(P<0.05),BCVA显著高于SRD组(P<0.05)。结论DRT型、CME型使用抗VEGF治疗后CMT显著降低,BCVA显著增高,治疗结局显著好于SRD型,不良反应发生率低于SRD型。

Objective To explore the efficacy of intravitreal anti-VEGF therapy for different patterns of optical coherence tomography of diabetic macular edema.Methods The retrospective study was conducted from April 2018 to April 2020,149 patients with diabetic macular edema(DME)who met the diagnostic criteria of euretina were treated with intravitreal anti-VEGF therapy in Anqing Hospital Affiliated to Anhui Medical University.They were divided into diffuse retinal thickening(DRT)group(75 cases),cystoid macular edema(CME)group(53 cases)and serous retinal detachment(SRD)group(31 cases)according to optical coherence tomography(OCT).To compare the clinical efficacy,best corrected visual acuity(BCVA),central macular thickness(CMT)and adverse reactions of different types of anti-VEGF therapy.Results The effective rate of DRT group and CME Group was significantly higher than that of SRD group(P<0.05);there was no significant difference in the effective rate between DRT group and CME Group(P>0.05);the CMT of DRT group,CME Group and SRD group after treatment was significantly lower than that before treatment(P<0.05),and the BCVA was significantly higher than that of SRD group(P<0.05);the comparison between groups after treatment showed that the CMT of DRT group and CME Group was significantly lower than that of SRD group(P<0.05),and the BCVA was significantly higher than that of SRD Group.The incidence of adverse reactions in DRT group and CME Group was significantly lower than that in SRD group(P<0.05).Conclusions After anti-VEGF treatment,CMT of DRT type and CME type was significantly decreased,BCVA of DRT type and CME type was significantly increased.The treatment outcome of DRT type and CME type was significantly better than that of SRD type,and the incidence of adverse reactions was lower than that of SRD type.