高度近视继发黄斑新生血管抗VEGF术后患者近期视力预后相关因素分析

Analysis of factors related to short-term visual prognosis in patients with high myopia secondary to macular neovascularization after anti VEGF surgery

目的探讨影响抗血管内皮细胞生长因子(VEGF)治疗高度近视继发黄斑新生血管(MNV)患者近期视力预后的相关因素。方法回顾性分析2021年1月至2023年6月在安徽理工大学第一附属医院眼科接受抗VEGF治疗的高度近视继发MNV患者28例(28只眼)的临床资料。以术后1个月最佳矫正视力(BCVA)分为视力预后不良组和视力预后良好组,对比两组患者术前眼部特征及相关生物参数并进行统计学分析。结果高度近视继发MNV患者抗VEGF治疗1个月后BCVA、黄斑中心凹厚度(CMT)、MNV面积,较术前均显著改善,差异均有统计学差异(Z=6.371,6.949,2.437,均P<0.05)。单因素分析显示,两组患者在眼轴长度、后巩膜葡萄肿、CMT改善、MNV面积改善上差异均有统计学意义(均P<0.05)。多因素Logistic回归分析显示,眼轴长度和术前MNV面积是影响MNV患者抗VEGF治疗后视力预后的独立影响因素(均P<0.05)。结论抗VEGF治疗高度近视继发MNV可有效提高患者视力,术后视力与眼轴长度、后巩膜葡萄肿、CMT改善、MNV面积改善相关,其中,眼轴长度和术前MNV面积是影响视力预后的独立影响因素。

Objective Explore the relevant factors that affect the short-term visual prognosis of patients with high myopic macular neovascularization(MNV)treated with anti vascular endothelial growth factor(VEGF).Methods Retrospective analysis of the clinical data of 28 cases(28 eyes)of high myopia with secondary MNV who received anti VEGF treatment at the Ophthalmology Department of the First Affiliated Hospital of Anhui University of Technology from January 2021 to June 2023.Divide the best corrected visual acuity(BCVA)one month after surgery into a poor visual prognosis group and a good visual prognosis group.Compare the preoperative eye characteristics and related biological parameters of the two groups of patients and conduct statistical analysis.Results After one month of anti VEGF treatment,the BCVA,central macular thickness(CMT),and MNV area of patients with high myopia secondary to MNV significantly improved compared to before surgery,with statistical differences(Z=6.371,6.949,2.437,P<0.05).Univariate analysis showed that there was a statistically significant difference in axial length,posterior staphyloma,CMT improvement,and MNV area improvement between the two groups of patients(both P<0.05).Multivariate Logistic regression analysis showed that axial length and preoperative MNV area were independent influencing factors for visual prognosis in MNV patients after anti VEGF treatment(P<0.05).Conclusions Anti VEGF therapy for high myopia secondary to MNV can effectively improve patients'vision.Postoperative vision is related to axial length,posterior staphyloma,improvement in CMT,and improvement in MNV area.Among them,axial length and preoperative MNV area are independent influencing factors on visual prognosis.