上海交通大学学报（医学版）

上海交通大学学报(医学版) ›› 2020, Vol. 40 ›› Issue (08): 1091-1097.doi: 10.3969/j.issn.1674-8115.2020.08.015

• 论著·临床研究 • 上一篇    下一篇

光学相干断层扫描血管成像在抗血管内皮生长因子药物治疗湿性年龄相关性黄斑变性效果评价中的应用

张 琼1，林仲静1，张士胜2，胡起维1，沈 玺1，徐建敏1   

  1. 1. 上海交通大学医学院附属瑞金医院眼科，上海200025；2. 上海希玛瑞视眼科医院，上海 200011
  • 出版日期:2020-08-28 发布日期:2020-08-28
  • 通讯作者: 徐建敏，电子信箱：xujianmin0919@sina.com。
  • 作者简介:张 琼（1972—），女，副主任医师，博士；电子信箱：joan_ss2004@sina.cn。
  • 基金资助:
    上海市科委西医引导项目（18411964900）。

Application of optical coherence tomography angiography to evaluation of clinical effect of anti-vascular endothelial growth factor agents on wet age-related macular degeneration

ZHANG Qiong1, LIN Zhong-jing1, ZHANG Shi-sheng2, HU Qi-wei1, SHEN Xi1, XU Jian-min1   

  1. 1. Department of Ophthalmology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; 2. C-MER (Shanghai) Vision Eye Hospital, Shanghai 200011, China
  • Online:2020-08-28 Published:2020-08-28
  • Supported by:
    Western Medicine Guidance Project of Shanghai Science and Technology Commission (18411964900).

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摘要： 目的·应用光学相干断层扫描血管成像（optical coherence tomography angiography，OCTA）辅助评价玻璃体腔注射抗血管内皮生长因子（vascular endothelial growth factor，VEGF）药物治疗湿性年龄相关性黄斑变性(age-related macular degeneration，AMD)的效果。方法·回顾性分析2018年4月—12月在上海交通大学医学院附属瑞金医院眼科确诊并治疗的31例湿性AMD患者（每例1眼）的临床资料。所有患者均行玻璃体腔注射抗VEGF药物，每月1次，连续注射3个月。比较治疗前及首次注射后1、2、3个月患者的最佳矫正视力(best-corrected visual acuity，BCVA)；OCTA检测治疗前后不同时间点的黄斑中心凹视网膜厚度、脉络膜新生血管（choroidal neovascularization，CNV）面积，并进行比较。结果·纳入研究的31例湿性AMD患者治疗前的平均BCVA（用最小分辨角对数表示）为0.93±0.43，治疗后均较治疗前有显著改善（均P<0.05）。OCTA检查结果显示，治疗前患者的黄斑中心凹内界膜-视网膜色素上皮层和内界膜-视网膜色素上皮层贴合处厚度分别为（329.03±110.73）μm和（468.84±209.50）μm，治疗后两者厚度均较治疗前显著减小（均P<0.05）；治疗前患者平均CNV面积为（4.78±3.24）mm2，治疗后CNV面积随时间推移逐渐缩小（均P<0.05）。结论·玻璃体腔注射抗VEGF药物可减轻湿性AMD患者的黄斑水肿，抑制CNV；OCTA可用于辅助评价玻璃体腔注射抗VEGF药物治疗湿性AMD的效果。

关键词: 光学相干断层扫描血管成像, 年龄相关性黄斑变性, 抗血管内皮生长因子药物

Abstract:

Objective · To apply optical coherence tomography angiography (OCTA) to evaluate the clinical effects of intravitreal injection of anti-vascular endothelial growth factor (VEGF) agents on wet age-related macular degeneration (AMD). Methods · The 31 eyes of 31 wet AMD patients in the Department of Ophthalmology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from April 2018 to December 2018 were included. These patients received monthly intravitreal injection of anti-VEGF agents for three consecutive months. The best-corrected visual acuity (BCVA) before and 1, 2 and 3 months after first injection was compared. The macular fovea thickness and choroidal neovascularization (CNV) area at different time points before and after treatment were detected by OCTA and compared. Results · The baseline BCVA (logarithm of the minimum angle of resolution) of the included patients was 0.93±0.43, and the BCVA was significantly improved after treatment (P<0.05). The results of OCTA showed that before treatment the inner limiting membrane-retinal pigment epithealium thickness and inner limiting membrane-retinal pigment epithelial fit thickness were (329.03±110.73) μm and (468.84±209.50) μm, respectively, and they both decreased significantly after treatment (P<0.05). The CNV area before treatment was (4.78±3.24) mm2, and it decreased gradually with time after treatment (P<0.05). Conclusion · Intravitreal injection of anti-VEGF agents can reduce macular edema and inhibit CNV in the wet AMD patients. OCTA can be used to evaluate the efficacy of intravitreal injection of anti-VEGF agents in the treatment of wet AMD.

Key words: optical coherence tomography angiography (OCTA), age-related macular degeneration (AMD), anti-vascular endothelial growth factor (VEGF) agent

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