Ozurdex与抗VEGF药物对糖尿病性黄斑水肿的疗效分析

Effect Analysis of Ozurdex and Anti-VEGF Drugs On Diabetic Macular Edema

目的比较Ozurdex与抗血管内皮生长因子(VEGF)药物对糖尿病性黄斑水肿(DME)的疗效。方法回顾性病例分析研究。收集2020年1月至2023年3月期间在安徽理工大学第一附属医院(淮南市第一人民医院)眼科进行玻璃体腔药物注射的DME患者23例(28只眼)。根据患者选择的治疗方案及注药的规律性分为三组:抗VEGF1组:患者玻璃体内注射抗VEGF药物(雷珠单抗、康柏西普、阿柏西普)0.05 ml,每月规律注射,连续注射3次,总治疗时间为12周,共7例(9只眼);抗VEGF2组:患者玻璃体内注射抗VEGF药物(0.05 ml),连续注射3次,注射不规律,两次注射之间间隔时间4~6周,总治疗时间在12~14周,共8例(10只眼);玻璃体内地塞米松植入(IDI)组:患者进行一次玻璃体内注射Ozurdex(0.7 mg),共8例(9只眼)。利用频域相干光层析成像术(SD-OCT)监测三组患者16周内黄斑中心凹视网膜厚度(CMT)的变化情况。结果IDI组与抗VEGF1组12周内CMT明显下降且下降程度相当,均值均小于300μm;抗VEGF2组CMT在12~14周内CMT处于波动中,且均值高于300μm;IDI组CMT在治疗后8周内持续下降,8周时达最低值,12周时CMT略回升;抗VEGF1组在治疗后12周内CMT持续下降,治疗16周后三组CMT均恢复至较高水平(高于300μm),均需再治疗。结论Ozurdex与抗VEGF药物均可明显改善DME患者黄斑中心凹的解剖形态,Ozurdex可在12周内稳定的维持黄斑部较正常的解剖学形态,抗VEGF药物疗效需依赖患者的依从性,按时复诊治疗的患者可在12周内维持较为良好的黄斑部解剖学形态。

Objective To compare the efficacy of Ozurdex and anti-VEGF drugs on Diabetic Macular Edema(DME).Methods Retrospective analysis was used.A total of 28 eyes of 23 DME patients who underwent intravitreal drug injection in the ophthalmology department of the First Affiliated Hospital of Anhui University of Science and Technology(Huainan First People's Hospital)from January 2020 to March 2023 were collected.The patients were divided into three groups according to the treatment plan chosen by the patients and the rule of injection:anti-VEGF1 group:the patients re⁃ceived intravitreal injection of anti-VEGF drugs(leizμmab,Compaximab,arbocept)of 0.05ml,regular injection three times a month,the total treatment time was 12 weeks,a total of 7 cases(9 eyes);Anti-VEGF2 group:8 patients(10 eyes)re⁃ceived intravitreal injection of anti-VEGF drug(0.05 ml)for 3 consecutive times with irregular injection interval of 4~6 weeks.The total treatment time was 12~14 weeks.IDI group:8 patients(9 eyes)received a single intravitreal injection of Ozurdex(0.7 mg).SD-OCT was used to monitor the changes of CMT in the three groups within 16 weeks.Results CMT in IDI group and anti-VEGF1 group decreased significantly and to the same extent in 12 weeks,and the mean value was less than 300μm.In the anti-VEGF2 group,CMT fluctuated in 12~14 weeks,and the mean value was higher than 300μm.In IDI group,CMT continued to decrease within 8 weeks after treatment,reached the lowest value at 8 weeks,and increased slightly at 12 weeks.In the anti-VEGF1 group,CMT continued to decline within 12 weeks after treatment,and after 16 weeks of treatment,CMT in all three groups recovered to a higher level(above 300μm),and all needed to be treated again.Conclusions Ozurdex and anti-VEGF drugs can significantly improve the anatomical morphology of macular fovea in DME patients,and Ozurdex can stably maintain the relatively normal anatomical morphology of macular within 12 weeks,while the efficacy of anti-VEGF drugs depends on the compliance of patients,and patients who return to the clinic on time can maintain relatively good anatomical morphology of macular within 12 weeks.