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Reasons for not improving visual acuity of DME patients due to interruption of anti-VEGF therapy during the pandemic and OCT imaging analysis
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- Author:
- No author available
- Journal Title:
- International Eye Science
- Issue:
- 12
- DOI:
- 10.3980/j.issn.1672-5123.2022.12.28
- Key Word:
- 糖尿病性黄斑水肿;中断治疗;光学相干断层扫描;高反射点;新型冠状病毒肺炎疫情
Abstract： 目的:分析因新型冠状病毒肺炎疫情中断治疗后糖尿病性黄斑水肿(DME)患者再次行抗血管内皮生长因子(VEGF)治疗患者视力不提高的原因以及与OCT影像学特征的相关性.方法:回顾性病例研究.选择2019-12/2020-07于西安交通大学第一附属医院眼科行抗VEGF药物治疗的DME患者31例40眼,纳入患者均有因新冠疫情中断治疗的病史,根据再次治疗后1mo最佳矫正视力(BCVA)提高1行为标准分为视力提高组14眼和视力不提高组26眼.所有患者均接受全面的眼科检查,包括BCVA、眼压、光学相关断层扫描(OCT)、眼底照相和眼底荧光血管造影(FFA),使用Image J软件对黄斑OCT图像中的中央视网膜厚度(CRT)、高反射物质(HRD)、视网膜下液(SRF)、视网膜内低反射囊腔(IRF)、视网膜内层结构紊乱(DRIL)和椭圆体带破坏(EZD)进行量化分析.采用Sperman相关分析治疗后1mo BCVA与CRT、HRD数量、SRF和IRF的直径与高度DRIL和EZD宽度之间的相关性.结果:视力不提高组患者OCT中HRD出现的比例明显高于视力提高组(χ2=5.43,P=0.0072);DME患者经治疗前后BCVA(LogMAR)差值与CRT差值呈正相关(rs=0.406,P=0.009),治疗后BCVA(LogMAR)与治疗后EZD宽度呈正相关(rs=0.358,P=0.023).治疗后BCVA(LogMAR)分别与治疗后CRT(rs=-0.086,P=0.600)、HRD数量(rs=-0.115,P=0.482)、SRF的直径与高度(rs=0.102,P=0.530;rs=0.100,P=0.538)、IRF的直径与高度(rs=0.134,P=0.410;rs=-0.014,P=0.932)以及DRIL宽度(rs=0.089,P=0.587)之间无相关性.结论:因为新冠疫情中断治疗后再次行抗VEGF治疗视力无提高的患者出现视网膜HRD的概率明显高于视力提高的患者,EZD宽度也与预后视力密切相关,针对此类患者可综合OCT中HRD表现,必要时玻璃体腔注射糖皮质激素抗炎作为辅助策略.
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