湿性年龄相关性黄斑变性患眼玻璃体内注射抗VEGF药物前后OCTA变化及与视力的相关性研究

Changes in OCTA before and after intravitreal injection of anti-VEGF drugs in eyes with wet age-related macular degeneration and its correlation with visual acuity

目的 探讨湿性年龄相关性黄斑变性(wet age-related macular degeneration,wAMD)患眼玻璃体内注射抗血管内皮生长因子(vascular endothelial growth factor,VEGF)药物前后光学相干断层扫描血管成像(optical coherence tomography angiography,OCTA)变化及与视力的相关性。方法 回顾性72例接受玻璃体内注射抗VEGF药物治疗的wAMD患者(72眼)的资料,比较患者治疗前后病灶切面面积(cross sectional area,CSA)、血流面积(cross flow area,CFA)、黄斑中心凹视网膜厚度(central macular thickness,CMT)变化,采用标准对数视力表检查患者治疗前后最佳矫正视力(best corrected visual acuity,BCVA),并换算成LogMAR视力表数值,采用Pearson相关性分析wAMD患眼抗VEGF药物治疗前后CSA、CFA、CMT的差值与治疗前后BCVA(LogMAR)的差值的关系,统计患者治疗效果,采用Logistic回归分析影响wAMD患眼抗VEGF药物治疗无效的因素。结果 wAMD患眼抗VEGF药物后CSA、CFA、CMT均低于治疗前(P<0.05);wAMD患眼抗VEGF药物治疗后BCVA(LogMAR)低于治疗前(P<0.05);经Pearson相关性分析,wAMD患眼抗VEGF药物治疗前后CSA、CFA、CMT的差值与治疗前后BCVA(LogMAR)的差值均呈正相关(P<0.05)。Logistic多因素回归分析显示术前眼压、治疗前CSA、CFA、CMT均是影响wAMD患眼抗VEGF药物治疗无效的相关因素(P<0.05)。结论 wAMD患眼抗VEGF药物治疗前后CSA、CFA、CMT的差值与治疗前后BCVA(LogMAR)的差值均呈正相关,且CSA、CFA、CMT均是影响wAMD患眼抗VEGF药物治疗效果的相关因素。

Objective To explore the changes in optical coherence tomography angiography(OCTA)of eyes with wet age-related macular degeneration(wAMD)before and after intravitreal injection of anti-vascular endothelial growth factor(VEGF)drugs and its correlation with visual acuity.Methods The data of 72 wAMD patients(72 eyes)who received intravitreal injection of anti-VEGF drugs were retrospectively analyzed,and the changes of cross sectional area(CSA),cross flow area(CFA),and central macular thickness(CMT)before and after treatment were compared.The standard logarithmic visual acuity chart was used to check the patient's best corrected visual acuity(BCVA)before and after treatment,which was converted into LogMAR visual acuity chart values.Pearson correlation analysis was used to analyze the relationship between difference of CSA,CFA,CMT and difference of BCVA(LogMAR)before and after treatment with anti-VEGF drugs in wAMD eyes,and the therapeutic effect of patients was calculated.Logistic regression analysis was used to analyze the factors influencing the ineffectiveness of anti-VEGF drug treatment in wAMD eyes.Results CSA,CFA and CMT after anti-VEGF drugs in wAMD eyes were lower than those before treatment(P<0.05).BCVA(LogMAR)after anti-VEGF drug treatment in wAMD eyes was lower than that before treatment(P<0.05).According to Pearson correlation analysis,difference of CSA,CFA,CMT before and after anti-VEGF drug treatment in wAMD eyes were positively correlated with difference of BCVA(LogMAR)(P<0.05).Logistic multivariate regression analysis showed that preoperative intraocular pressure,pretreatment CSA,CFA,and CMT were related factors that affected the ineffectiveness of anti-VEGF drug treatment in wAMD eyes(P<0.05).Conclusion Difference of CSA,CFA,CMT before and after treatment with anti-VEGF drugs in wAMD eyes are positively correlated with difference of BCVA(LogMAR)before and after treatment,and CSA,CFA,and CMT are all related factors that affect the therapeutic effect of anti-VEGF drugs in wAMD eyes.