摘要
目的探讨光学相干断层扫描(OCT)参数在视网膜静脉阻塞伴黄斑水肿(RVO-ME)患者微血管结构评估及抗血管内皮生长因子(VEGF)治疗中的应用效果。方法回顾性分析2022年4月至2023年5月首都医科大学附属北京安贞医院南充医院南充市中心医院收治的102例RVO-ME患者的临床资料,根据是否接受抗VEGF治疗分为对照组47例(未接受抗VEGF治疗)和观察组55例(接受抗VEGF治疗)。所有患者在治疗前和治疗3个月后接受OCT检查,记录黄斑中心视网膜厚度(CMT)、黄斑体积(MV)、视网膜厚度(RT)及椭圆带(EZ)完整性,并检测VEGF水平及最佳矫正视力(BCVA)变化。采用Pearson相关分析BCVA、VEGF水平与OCT参数之间的相关性。结果治疗3个月后,观察组和对照组患者的CMT[(420.25±32.47)μm vs(459.28±31.12)μm]、MV[(8.12±1.45)mm^(3)vs(9.65±1.28)mm3]和RT[(315.26±28.11)μm vs(342.32±24.16)μm]比较,观察组明显低于对照组,而EZ完整性[(75.60±4.31)%vs(68.41±4.28)%]比较,观察组明显高于对照组,差异均有统计学意义(P<0.05);观察组患者的治疗前的VEGF水平为(142.53±25.71)pg/mL,治疗后为(122.21±17.93)pg/mL,差异均有统计学意义(P<0.05);治疗3个月后,观察组和对照组患者的BCVA[(0.56±0.21)LogMAR vs(0.92±0.25)LogMAR]比较,观察组明显低于对照组,差异均有统计学意义(P<0.05);Pearson相关分析结果显示,BCVA和VEGF水平与CMT、MV、RT、EZ完整性均呈正相关(P<0.05)。结论OCT参数能有效评估RVO-ME患者的微血管结构变化,抗VEGF治疗可明显改善患者的黄斑水肿,恢复视网膜微血管结构。
Objective To investigate the application of optical coherence tomography(OCT)parameters in evaluating microvascular structure and the efficacy of anti-vascular endothelial growth factor(VEGF)therapy in patients with retinal vein occlusion and macular edema(RVO-ME).Methods The clinical data of 102 patients with RVO-ME in Nanchong Hospital of Beijing Anzhen Hospital of Capital Medical University·Nanchong Central Hospital were retrospectively analyzed from April 2022 to May 2023.According to whether the patients received anti-VEGF treatment,they were divided into a control group(47 cases,without anti-VEGF treatment)and an observation group(55 cases,with anti-VEGF treatment).All patients received OCT examination before treatment and after 3 months of treatment.The central macular thickness(CMT),microvessel density(MV),retinal thickness(RT),and elliptic zone(EZ)integrity were recorded,and the changes of VEGF and best corrected visual acuity(BCVA)were detected.Pearson correlation analysis was adopted to analyze the correlation between BCVA,VEGF and OCT parameters.Results After 3 months of treatment,the CMT,MV,and RT in the observation group were significantly lower compared with those in the control group(P<0.05):(420.25±32.47)μm vs(459.28±31.12)μm;(8.12±1.45)mm^(3)vs(9.65±1.28)mm^(3);(315.26±28.11)μm vs(342.32±24.16)μm,while EZ integrity was significantly higher compared with that in the control group(P<0.05):(75.60±4.31)%vs(68.41±4.28)%.VEGF level in the observation group decreased significantly from(142.53±25.71)pg/mL before treatment to(122.21±17.93)pg/mL after treatment(P<0.05).After 3 months of treatment,BCVA in the observation group was significantly better than in the control group(P<0.05):(0.56±0.21)LogMAR vs(0.92±0.25)LogMAR,P<0.05.Pearson correlation analysis found that BCVA and VEGF were positively correlated with CMT,MV,RT and EZ integrity(P<0.05).Conclusion OCT parameters can effectively evaluate the changes of microvascular structure in RVO-ME patients.Anti-VEGF treatment can significantly improve macular edema and restore retinal microvascular structure.
作者
罗云霞
徐晓霞
杨宇
LUO Yun-xia;XU Xiao-xia;YANG Yu(Department of Ophthalmology,Nanchong Hospital of Beijing Anzhen Hospital of Capital Medical University·Nanchong Central Hospital,Nanchong 637000,Sichuan,CHINA)
出处
《海南医学》
2025年第6期800-803,共4页
Hainan Medical Journal
基金
四川省卫生健康委员会科研课题普及应用项目(编号:20PJ300)。
