玻璃体腔抗VEGF治疗不同光学相干层析成像技术分型下的糖尿病黄斑水肿临床疗效分析

Clinical Effect Analysis of Vitreous Anti-VEGF Therapy on Diabetic Macular Edema with Different Optical Coherence Tomography

目的:研究玻璃体腔内抗血管内皮生长因子(VEGF)抗体治疗不同光学相干层析成像技术(OCT)分型下的糖尿病黄斑水肿临床疗效。方法:选取2019年1月到2021年3月在我院进行治疗的糖尿病黄斑水肿患者60例,根据OCT检测分为分弥漫性黄斑水肿(DRT)组、囊样黄斑水肿(CME)组和浆液性视网膜脱离(SRD)组,每组20例。所有患者均接受玻璃体腔内注射抗VEGF抗体治疗,比较三组患者临床治疗疗效、黄斑水肿形态、最佳矫正视力(BCVA)、黄斑中心凹厚度(CMT)以及不良反应发生率。结果:(1)DRT、CME和SRD组患者临床治疗有效率分别为85.0%、75.0%和50.0%,治疗后黄斑水肿消退率分别为55.0%、25.0%和10.0%,且组间比较差异显著(P<0.05);(2)三组患者治疗前BCVA和CMT均无差异(P>0.05),治疗后三组患者BCVA和CMT均降低(P<0.05),并且治疗后DRT和CME组患者BCVA和CMT均低于SRD组(P<0.05);(3)DRT、CME和SRD组患者治疗期间不良反应发生率分别为10.0%、10.0%和25.0%,但三组患者治疗期间不良反应发生率比较无差异(P>0.05)。结论:不同OCT分型的糖尿病黄斑水肿经玻璃体腔抗VEGF抗体治疗后临床疗效不同,其中DRT患者临床治疗疗效最好,而SRD患者疗效最差。

Objective:To study the clinical efficacy of anti-VEGF antibody in the vitreous cavity for treatment of diabetic macular edema under different optical coherence tomography(OCT) classifications.Methods:A selection of 60 patients with diabetic macular edema who were treated in our hospital from January 2019 to March 2021 were divided into diffuse macular edema(DRT) group,cystoid macular edema(cME) group and serous retina based on OCT detection Disengagement(SRD) group,20 cases in each group.All patients received intravitreal injection of anti-VEGF antibody treatment.The three groups of patients were compared with clinical treatment efficacy,macular edema morphology,best corrected vision acuity(BCVA),central macular thickness(CMT) and the incidence of adverse reactions.Results:(1) The effective rates of clinical treatment in the DRT,CME and SRD groups were 85.0 %,75.0 %,and 50.0 %,respectively,and the regression rates of macular edema post-treatment were 55.0%,25.0%,and 10.0%,respectively,and the differences between the groups were significant(P0.05),and the BCVA and CMT of the three groups of patients were reduced post-treatment(P0.05).Conclusion:Different OCT types of diabetic macular edema have different clinical effects after vitreous anti-VEGF antibody treatment.Among them,DRT patients have the best clinical treatment effect,while SRD patients have the worst effect.