CAJ | 학술논문

目的评价湿性年龄相关性黄斑变性(AMD)患者抗血管内皮生长因子(VEGF)治疗后术眼OCT参数与视力之间的相关性.方法 32例32只眼湿性AMD患者接受抗VEGF治疗后5-6月,记录患者最佳矫正视力,同一天进行频域OCT扫描,对黄斑中心凹厚度(FT),黄斑中心区厚度(CST),黄斑区容积(CV),黄斑区平均厚度(CAT),视网膜下液(SRF),视网膜内液(IRF),脉络膜新生血管膜厚度(CN-VMT)等参数进行分析,并根据成像质量进行手动校正,探讨术眼最佳矫正视力与OCT各参数之间的关系.结果对32例患者的结果分析显示,在CST>210um的患者中,术眼最佳矫正视力(LogMar视力)与校正前后的FT、CV及CAT均无相关性;与校正前后的CST有相关性,相关系数分别为r=0.396,P=0.041;r=0.447,P=0.019,校正后的相关性更强.有视网膜内液组和无视网膜内液组的LogMar视力分别为1.14±0.54和0.64.4±0.49,两组差异有统计学意义(t=2.66 P=0.012). CNV显著组和CNV不显著组的LogMar视力分别0.98 4±0.61,0.57 4±0.34,两组差异有统计学意义(t=2.205 P=0.035).结论湿性AMD患者抗VEGF治疗后最佳矫正视力(LogMar视力)与校正后的中心区厚度呈正相关.手动校正中心凹位置对正确判断AMD患者抗VEGF治疗的效果十分必要.
목적 평개습성년령상관성황반변성(AMD)환자항혈관내피생장인자(VEGF)치료후술안OCT삼수여시력지간적상관성.방법 32례32지안습성AMD환자접수항VEGF치료후5-6월,기록환자최가교정시력,동일천진행빈역OCT소묘,대황반중심요후도(FT),황반중심구후도(CST),황반구용적(CV),황반구평균후도(CAT),시망막하액(SRF),시망막내액(IRF),맥락막신생혈관막후도(CN-VMT)등삼수진행분석,병근거성상질량진행수동교정,탐토술안최가교정시력여OCT각삼수지간적관계.결과 대32례환자적결과분석현시,재CST>210um적환자중,술안최가교정시력(LogMar시력)여교정전후적FT、CV급CAT균무상관성;여교정전후적CST유상관성,상관계수분별위r=0.396,P=0.041;r=0.447,P=0.019,교정후적상관성경강.유시망막내액조화무시망막내액조적LogMar시력분별위1.14±0.54화0.64.4±0.49,량조차이유통계학의의(t=2.66 P=0.012). CNV현저조화CNV불현저조적LogMar시력분별0.98 4±0.61,0.57 4±0.34,량조차이유통계학의의(t=2.205 P=0.035).결론 습성AMD환자항VEGF치료후최가교정시력(LogMar시력)여교정후적중심구후도정정상관.수동교정중심요위치대정학판단AMD환자항VEGF치료적효과십분필요.
Objective To evaluate the macular structure following anti-VEGF therapy in wet AMD patients and to study the correlation of structural findings with visual acuity outcomes, using spectral domain optical coherence tomography (SD-OCT). Methods Thirty-two cases (32 eyes) with wet AMD after anti-VEGF therapy were included in the study.Ophthalmic examination included best-corrected visual acuity (BCVA), dilated fundus examination and OCT imaging 5-6 months after anti-VEGF therapy.Macular thickness and volume were calculated for morphologic parameters of interest including fovea thickness (FT), central subfield thickness (CST), cube volume (CV), cube average thickness (CAT), subretinal fluid (SRF), intraretinal fluid (IRF), CNV membrane thickness (CNVMT) before and after manually identification of fovea.The correlation between BCVA and OCT parameters were investigated.Results Increased CST was correlated with decreased visual acuity (r =0.447, P=0.019), both pre- and post- manually correction.The association was stronger after manually correction if compared with that before correction.No statistically significant association was detected between BCVA and FT, CA and CAT pre- and post-correction.Decreased visual acuity was also correlated with the presence of the IRF and thicker CNV membrane in the macular region.Con- clusions The manually-corrected CST is strongly correlated with BCVA after anti-VEGF therapy in wet AMD patients. Because of the poor visual function and central fixation in these patients due to the complex macular lesions, manually correction of fovea in OCT analysis is definitely necessary in AMD patients.