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引用:李婵,陆慧琴,索琰.OCTA在地塞米松玻璃体内植入剂治疗RVO-ME短期疗效观察中的应用.国际眼科杂志 2020;20(8):1468-1472,doi:10.3980/j.issn.1672-5123.2020.8.38
OCTA在地塞米松玻璃体内植入剂治疗RVO-ME短期疗效观察中的应用
OCTA as evaluation methods for the efficacy and safety of Dexamethasone intravitreal implants for retinal vein occlusion-related macular edema
投稿时间:2020-01-01  修订日期:2020-07-08
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DOI:10.3980/j.issn.1672-5123.2020.8.38
关键词:  视网膜静脉阻塞  黄斑水肿  黄斑中心凹厚度  光相干断层扫描血管成像技术  地塞米松玻璃体内植入剂
Key Words:  retinal vein occlusion  macular edema  central retinal thickness  OCT angiography  intravitreal dexamethasone implant
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李婵 中国陕西省西安市第一医院 西北大学附属第一医院
陆慧琴 中国陕西省西安市第一医院 西北大学附属第一医院
索琰 中国陕西省西安市第一医院 西北大学附属第一医院
        
AuthorInstitution
Chan Li Xi'an No.1 Hospital; First Affiliated Hospital of Northwest University, Xi'an , Shaanxi Province, China
Hui-Qin Lu Xi'an No.1 Hospital; First Affiliated Hospital of Northwest University, Xi'an , Shaanxi Province, China
Yan Suo Xi'an No.1 Hospital; First Affiliated Hospital of Northwest University, Xi'an , Shaanxi Province, China
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目的:以地塞米松玻璃体内植入剂(IDI)玻璃体腔注射治疗视网膜静脉阻塞继发黄斑水肿(RVO-ME),利用光相干断层扫描血管成像技术(OCTA)等检查评价其短期疗效及安全性。

     方法:对确诊为RVO-ME患者17例17眼进行玻璃体腔注射IDI治疗,分别于治疗前,治疗后1d,1、2、3、4、6mo等时间点测定患者最佳矫正视力(BCVA)、眼内压(IOP)、黄斑中心凹厚度(CMT),观察浅、深层视网膜血管网变化。

     结果:患者17眼经IDI治疗后24h患者CMT明显下降,且随着时间的推移,CMT整体亦呈下降趋势,在3mo随访时,CMT改善较为明显; 视力改善与CMT变化一致; OCTA显示视网膜血管网较基线期恢复。IDI注射治疗后共有2眼出现轻度眼压增高,用药后均可恢复至正常。随访期间未见与注射及药物治疗相关不适及副作用。

     结论:玻璃体腔注射IDI治疗视网膜静脉阻塞继发黄斑水肿的短期疗效确切,对患者视力提升明显,且安全性较高,未见明显不良反应发生。OCTA可以观察到黄斑水肿明显减轻,浅、深层视网膜血管网血管迂曲和扩张显著改善。

Abstract:
      AIM:To evaluate the short-term efficacy and safety of intravitreal dexamethasone implant(IDI)for patients with retinal vein occlusion-related macular edema(RVO-ME)by using optical coherence tomography(OCTA).

     METHODS: Seventeen eyes in 17 patients with RVO-ME were treated with intravitreal injection of sustained-release IDI. The best corrected visual acuity(BCVA), central macular thickness(CMT)and superficial retinal vascular network were observed at baseline, 1d, 1mo, 2mo, 3mo, 4mo and 6mo.

     RESULTS: CMT was significantly reduced from baseline by 24h after injection and improved further during the 3mo follow-up, and the improvement of visual acuity was consistent with that of CMT. OCTA showed improvement from baseline in terms of decreased number and size of cysts and restoration of the retinal vascular network. A slight increase in intraocular pressure was observed in 2 eyes after injection. There were no systemic side effects associated with injection or medication during follow-up.

     CONCLUSION: CMT reduced as early as 24h after the injection of IDI, with further reduction during follow-up, and OCTA could visually observe the changes of retinal vascular network in macular area.

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