山东大学耳鼻喉眼学报 ›› 2022, Vol. 36 ›› Issue (6): 101-105.doi: 10.6040/j.issn.1673-3770.0.2022.345

• 论著 • 上一篇    

视网膜下高反射物质在抗VEGF治疗nAMD患者中对视力预后的影响

王露萍1,寇芳柠2,王皓3,张灿伟4,王艳玲1,尤冉1,吴伟珍1   

  1. 山东省千佛山医院)眼科, 山东 济南 250014
  • 发布日期:2022-12-07
  • 通讯作者: 吴伟珍. E-mail:wuweizhen@mail.ccmu.edu.cn;尤冉. E-mail:ranynnnnn@sina.com
  • 基金资助:
    国家自然科学基金(82000899)

Effects of subretinal hyperreflective material on the visual prognosis of anti-VEGF therapy in patients with neovascular macular degeneration

WANG Luping1, KOU Fangning2, WANG Hao3, ZHANG Canwei4, WANG Yanling1, YOU Ran1, WU Weizhen1   

  1. 1. Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China;
    2. Department of Ophthalmology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China;
    3. Department of Clinical Epidemiology and Evidence-Based Medicine, Beijing Clinical Research Institute, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China;
    4. Department of Ophthalmology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan 250014, Shandong, China
  • Published:2022-12-07

摘要: 目的 探讨视网膜下高反射物质(SHRM)对抗血管内皮生长因子治疗新生血管性年龄相关性黄斑变性(nAMD)患者视力预后的影响。 方法 回顾性分析确诊为nAMD的50例患者(50眼)。将患者分为2组,视力提高组共27眼,视力未提高组共23眼,分析SHRM是否影响患者视力预后。通过对比基线和终点有无SHRM,患者基线和终点视力有无差异,评价SHRM在治疗前后对患者视力的影响。 结果 两组患者性别、年龄、基线最佳矫正视力(BCVA)、基线中心凹厚度(CMT)、基线SHRM宽度和高度、注射次数差异均无统计学意义。治疗12个月后,视力提高组患者CMT(P=0.027)、SHRM宽度(P=0.036)和高度(P=0.027)均小于视力未提高组。此外,存在基线SHRM的nAMD患者,基线BCVA低于无基线SHRM的患者(P=0.022);无基线/终点SHRM的患者,终点BCVA明显优于存在基线/终点SHRM的患者(P=0.015,P=0.008)。 结论 终点视力较基线视力提高的患者,SHRM宽度和高度较小;存在基线或终点SHRM的患者视力预后较差。SHRM可能作为nAMD患者的光学相干断层扫描生物标志物,协助眼科医生预测患者视力预后。

关键词: 新生血管性黄斑变性, 湿性黄斑变性, 视网膜下高反射物质, 抗血管内皮生长因子, 视网膜下纤维化

Abstract: Objective This study aimed to investigate the effect of subretinal hyperreflective material(SHRM)on the visual prognosis of neovascular macular degeneration(nAMD)patients with anti-vascular endothelial growth factor. Methods A total of 50 patients(50 eyes)diagnosed with nAMD were retrospectively analyzed. To determine whether SHRM affects the visual prognosis of these patients, they were divided into two groups. A total of 27 and 23 patients were grouped into the improved vision and non-improved vision groups, respectively. The effects of SHRM on the visual acuity of patients before and after treatment were evaluated by comparing the baseline and end points with or without SHRM. Results Before the treatment, no significant differences in sex, age, baseline best-corrected visual acuity(BCVA), baseline central macular thickness(CMT), baseline width and height of the SHRM, or injection times were observed between the two groups. After 12 months of treatment, CMT(P=0.027), width(P=0.036), and height(P=0.027)of SHRM were significantly lower in the improved vision group than those in the non-improved vision group. Furthermore, patients with nAMD who had baseline SHRM had a lower baseline BCVA than those without baseline SHRM(P=0.022). Patients without baseline or endpoint SHRM had significantly better endpoint BCVA than those with baseline or endpoint SHRM(P=0.015, P=0.008). Conclusion Patients that endpoint visual acuity better than baseline had lower SHRM width and height. On the other hand, patients with baseline or endpoint SHRM had poorer visual prognoses. SHRM may be used as an optical coherence tomography biomarker to assist ophthalmologists in predicting the visual prognosis of patients with nAMD.

Key words: Neovascular age-related macular degeneration, Wet age-related macular degeneration, Subretinal hyperreflective material, Anti-vascular endothelial growth factor, Subretinal fibrosis

中图分类号: 

  • R774.5
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