VISUAL AND MORPHOLOGIC OUTCOMES OF INTRAVITREAL RANIBIZUMAB FOR DIABETIC MACULAR EDEMA BASED ON OPTICAL COHERENCE TOMOGRAPHY PATTERNS
VISUAL AND MORPHOLOGIC OUTCOMES OF INTRAVITREAL RANIBIZUMAB FOR DIABETIC MACULAR EDEMA BASED ON OPTICAL COHERENCE TOMOGRAPHY PATTERNS
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DOI：
10.1097/iae.0000000000000770
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发表时间：
2016-03-01
影响因子：
3.3
通讯作者：
Kwak, Hyung Woo
中科院分区：
文献类型：
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作者：
Seo, Kyung Hoon;Yu, Seung-Young;Kwak, Hyung Woo
目的：根据光学相干断层扫描（optical coherence tomography，OCT）的形态学模式，评价玻璃体内注射雷珠单抗（intravitrealranibizumab，IVR）治疗糖尿病性黄斑水肿（diabetic macular edema，DME）患者的视觉和形态学效果。方法：对55例DME患者进行前瞻性连续系列OCT检查，根据OCT特征进行分类：弥漫性视网膜增厚（diffuse retinal thickening，DRT）、黄斑囊样水肿（cystoid macular edema，CME）和浆液性视网膜脱离（serous retinal detachment，SRD）。患者接受连续三个月的IVR注射，此后根据需要。主要结局是12个月内按DME类型进行的治疗次数。最佳矫正视力，视网膜厚度和显微结构的变化也evaluated.Results：眼睛被分类为DRT（n = 23），CME（16），或SRD（16）。12个月内的平均注射次数在各组之间存在显著差异：DRT（3.69）、CME（5.33）和SRD（5.09; P = 0.028）。12个月后，SRD的最佳矫正视力（20/60）明显低于其他类型（DRT = 20/38; CME = 20/43; P = 0.015）。特别是，DRT在较少的注射次数中保持了对雷珠单抗的良好反应。在基线时感光细胞完整性的破坏与较差的视觉结果相关，并且在SRD中更常见。
Purpose:To evaluate the visual and morphologic outcomes of intravitreal ranibizumab (IVR) in eyes with diabetic macular edema (DME) based on the morphologic pattern on optical coherence tomography.Methods:A prospective and consecutive series of 55 eyes with DME was classified according to OCT features: diffuse retinal thickening (DRT), cystoid macular edema (CME), and serous retinal detachment (SRD). Patients received three consecutive monthly injections of IVR and as needed thereafter. The primary outcome was the number of treatments undertaken by DME type over 12 months. Best-corrected visual acuity, retinal thickness, and microstructural changes were also evaluated.Results:The eyes were classified as DRT (n = 23), CME (16), or SRD (16). The mean number of injections over 12 months was significantly different among the groups: DRT (3.69), CME (5.33), and SRD (5.09; P = 0.028). Best-corrected visual acuity of SRD (20/60) was significantly worse than that of the other types (DRT = 20/38; CME = 20/43; P = 0.015) after 12 months.Conclusion:Vision gains and retinal anatomy improvement were maintained in all three types during the first year of IVR administration. Especially, DRT maintained a good response to ranibizumab in a fewer number of injections. Disruption of the photoreceptor integrity at the baseline was correlated with poorer visual outcome and occurred more frequently in SRD.