AIM: To investigate the contribution of fluorescein angiographic leaking microaneurysms (leak-MA) versus non-leaking microaneurysms (non-leak-MA) to retinal thickening in diabetic retinopathy.METHODS: A consecutive se...AIM: To investigate the contribution of fluorescein angiographic leaking microaneurysms (leak-MA) versus non-leaking microaneurysms (non-leak-MA) to retinal thickening in diabetic retinopathy.METHODS: A consecutive series of 38 eyes from 24 patients with diabetic retinopathy was included.Leak-MA and non-leak-MA in each eye were selected in pairs at corresponding topographic location.Leaking was defined by late phase fluorescein angiograms compared to early phase.Retinal thickness was measured with Heidelberg Spectralis OCT topographically aligned on early phase angiograms at the MA site and within a 1 mm circle.RESULTS: In all eyes,significant retinal thickening at the site of leaking compared to non-leaking microaneurysms was observed (356±69μm vs 318±56μm,P <0.001),showing a mean increase in thickness in the areas of leak-MA vs non-leak-MA of 38±39μm (95% confidence interval 2551μm,P<0.001).All 1mm area measurements also showed significant (P<0.001) thickening of the leak-MA with average thickness of leak-MA vs non-leak-MA as 351±67μmvs 319±59μm;minimum thickness 311±62μm vs 284±60μm;maximum thickness 389±78μm vs 352±66μm;and retina volume 26.4±6.0mmvs 23.6±3.7mm3,respectively.CONCLUSION: Leaking of microaneurysms on fluorescein angiography appears to cause focal thickening of retina,which can be measured with high-resolution OCT.Therefore,targeting leaking microaneursyms in diabetic retinopathy has the potential to reduce retinal thickening.展开更多
目的通过Meta分析探究玻璃体腔注射抗血管内皮生长因子(VEGF)药物治疗糖尿病视网膜微血管瘤的作用。方法检索PubMed、Cochrane Library、Embase、Web of Science等数据库建库至2020年12月31日关于使用抗VEGF药物玻璃体腔注射治疗糖尿病...目的通过Meta分析探究玻璃体腔注射抗血管内皮生长因子(VEGF)药物治疗糖尿病视网膜微血管瘤的作用。方法检索PubMed、Cochrane Library、Embase、Web of Science等数据库建库至2020年12月31日关于使用抗VEGF药物玻璃体腔注射治疗糖尿病视网膜病变(DR)的文献,使用RevMan5.3软件、Stata15.1软件进行Meta分析。结果共纳入9项研究,包括375例患者(413只眼)。与治疗前比较,DR患者玻璃体腔注射抗VEGF药物后视网膜微血管瘤数量减少,差异有统计学意义[SMD=-1.11,95%CI(-1.59,-0.63),Z=4.530,P=0.000]。对9项研究进行亚组分析,结果显示不同的抗VEGF药物(总体异质性:P=0.000,I^(2)=88.8%;阿柏西普亚组异质性:P=0.560,I^(2)=0.0%)和不同的微血管瘤计数方式(总体异质性:P=0.000,I^(2)=90.1%;荧光素血管造影亚组异质性:P=0.370,I^(2)=0.0%)是导致异质性的来源;但根据注药频率、检测时间、不同人种进行亚组分析时,组间差异均无统计学意义(P>0.05),尚不能认为上述因素是异质性来源。结论玻璃体腔注射抗VEGF药物能减少DR患者视网膜的微血管瘤数量,并且微血管瘤数量减少程度与抗VEGF药物的种类及计数方式相关。展开更多
文摘AIM: To investigate the contribution of fluorescein angiographic leaking microaneurysms (leak-MA) versus non-leaking microaneurysms (non-leak-MA) to retinal thickening in diabetic retinopathy.METHODS: A consecutive series of 38 eyes from 24 patients with diabetic retinopathy was included.Leak-MA and non-leak-MA in each eye were selected in pairs at corresponding topographic location.Leaking was defined by late phase fluorescein angiograms compared to early phase.Retinal thickness was measured with Heidelberg Spectralis OCT topographically aligned on early phase angiograms at the MA site and within a 1 mm circle.RESULTS: In all eyes,significant retinal thickening at the site of leaking compared to non-leaking microaneurysms was observed (356±69μm vs 318±56μm,P <0.001),showing a mean increase in thickness in the areas of leak-MA vs non-leak-MA of 38±39μm (95% confidence interval 2551μm,P<0.001).All 1mm area measurements also showed significant (P<0.001) thickening of the leak-MA with average thickness of leak-MA vs non-leak-MA as 351±67μmvs 319±59μm;minimum thickness 311±62μm vs 284±60μm;maximum thickness 389±78μm vs 352±66μm;and retina volume 26.4±6.0mmvs 23.6±3.7mm3,respectively.CONCLUSION: Leaking of microaneurysms on fluorescein angiography appears to cause focal thickening of retina,which can be measured with high-resolution OCT.Therefore,targeting leaking microaneursyms in diabetic retinopathy has the potential to reduce retinal thickening.
文摘目的通过Meta分析探究玻璃体腔注射抗血管内皮生长因子(VEGF)药物治疗糖尿病视网膜微血管瘤的作用。方法检索PubMed、Cochrane Library、Embase、Web of Science等数据库建库至2020年12月31日关于使用抗VEGF药物玻璃体腔注射治疗糖尿病视网膜病变(DR)的文献,使用RevMan5.3软件、Stata15.1软件进行Meta分析。结果共纳入9项研究,包括375例患者(413只眼)。与治疗前比较,DR患者玻璃体腔注射抗VEGF药物后视网膜微血管瘤数量减少,差异有统计学意义[SMD=-1.11,95%CI(-1.59,-0.63),Z=4.530,P=0.000]。对9项研究进行亚组分析,结果显示不同的抗VEGF药物(总体异质性:P=0.000,I^(2)=88.8%;阿柏西普亚组异质性:P=0.560,I^(2)=0.0%)和不同的微血管瘤计数方式(总体异质性:P=0.000,I^(2)=90.1%;荧光素血管造影亚组异质性:P=0.370,I^(2)=0.0%)是导致异质性的来源;但根据注药频率、检测时间、不同人种进行亚组分析时,组间差异均无统计学意义(P>0.05),尚不能认为上述因素是异质性来源。结论玻璃体腔注射抗VEGF药物能减少DR患者视网膜的微血管瘤数量,并且微血管瘤数量减少程度与抗VEGF药物的种类及计数方式相关。
