息肉样脉络膜血管病变患者频域光相干断层扫描图像特征与视力预后的相关性观察
식육양맥락막혈관병변환자빈역광상간단층소묘도상특정여시력예후적상관성관찰
Spectral domain optical coherence tomography characteristics of polypoidal choroidal vasculopathy and its correlation with vision outcomes
  • 万方数据
    中华眼底病杂志 중화안저병잡지
    CHINESE JOURNAL OF OCULAR FUNDUS DISEASES
    2014年 3期 241-244 ,共4页

    韦春宜%刘冉%李加青%杨宇%丁小燕

    위춘의%류염%리가청%양우%정소연

    诊断显像%体层摄影术,光学相干%脉络膜疾病/治疗%光化学疗法%抗体,单克隆 診斷顯像%體層攝影術,光學相榦%脈絡膜疾病/治療%光化學療法%抗體,單剋隆
    진단현상%체층섭영술,광학상간%맥락막질병/치료%광화학요법%항체,단극륭
    Diagnostic imaging%Tomography,optical coherence%Choroid diseases/therapy%Photochemotherapy%Antibodies,monoclonal
    目的 观察息肉样脉络膜血管病变(PCV)患者频域光相干断层扫描(SD-OCT)图像特征与光动力疗法(PDT)联合玻璃体腔注射雷珠单抗治疗视力预后的相关性.方法 吲哚青绿血管造影(ICGA)检查确诊的PCV患者26例26只眼纳入研究.所有患者治疗前、治疗后1、3、6个月行最佳矫正视力(BCVA)、裂隙灯显微镜联合前置镜、SD-OCT、荧光素眼底血管造影(FFA)、吲哚青绿血管造影(ICGA)检查.患眼基线平均BCVA(31.46±16.87)个字母;平均中心凹视网膜厚度(CRT) (581.19±309.05) μm;平均中心凹下脉络膜厚度(SFCT)(248.92±95.45)μm.根据联合治疗后6个月时BCVA改变情况,将患眼分为治疗敏感组(GR组)和治疗不敏感组(PR组),分别为17、9只眼.GR组17例中,男性12例,女性5例;平均年龄(65.24±7.03)岁;平均CRT为(619.06±335.07) μm;平均SFCT(271.24±106.61) μm.存在视网膜出血(SRH)、视网膜层间积液(IRF)、视网膜下液(SRF)、色素上皮脱离(PED)者分别为4、2、13、15只跟.PR组9例中,男性8例,女性1例;平均年龄(64.00±7.02)岁;平均CRT为(509.67±255.21) μm;平均SFCT(271.24±106.61) μm.存在SRH、IRF、PED者分别为6、5、6、8只眼.两组间性别、平均年龄、平均CRT、平均SFCT比较,差异无统计学意义(P＞0.05).比较两组基线时SD-OCT图像特征各参数与治疗后BCVA的关系,并行logistic回归分析.结果 治疗后1、2、3、6个月患眼平均BCVA分别为(38.46±19.81)、(40.04±20.80)、(42.96±21.63)、(43.77±20.91)个字母.治疗后6个月,GR组、PR组平均CRT分别为(360.71±276.54)、(341.44±193.68) μm.两组平均CRT比较,差异无统计学意义(P＞0.05).GR组SFCT≥263 μm者11只眼,占GR组患眼的64.71％.PR组SFCT≥263 μm者2只眼,占PR组患眼的22..22％.两组间SFCT≥263 μm者构成比比较,差异有统计学意义[比值比(OR):0.052,95％可信间区(CI):0.005～0.533;P=0.013].Logistic回归分析结果显示,治疗前存在IRF(OR=9.375,95％CI 1.299～67.645;P=0.026)、SRH(OR=6.500,95％CI 1.094～38.633;P=0.040)者对治疗反应差.结论 SFCT厚者对治疗敏感;治疗前存在IRF、SRH是影响治疗后视力的危险因素.
    목적 관찰식육양맥락막혈관병변(PCV)환자빈역광상간단층소묘(SD-OCT)도상특정여광동력요법(PDT)연합파리체강주사뢰주단항치료시력예후적상관성.방법 신타청록혈관조영(ICGA)검사학진적PCV환자26례26지안납입연구.소유환자치료전、치료후1、3、6개월행최가교정시력(BCVA)、렬극등현미경연합전치경、SD-OCT、형광소안저혈관조영(FFA)、신타청록혈관조영(ICGA)검사.환안기선평균BCVA(31.46±16.87)개자모;평균중심요시망막후도(CRT) (581.19±309.05) μm;평균중심요하맥락막후도(SFCT)(248.92±95.45)μm.근거연합치료후6개월시BCVA개변정황,장환안분위치료민감조(GR조)화치료불민감조(PR조),분별위17、9지안.GR조17례중,남성12례,녀성5례;평균년령(65.24±7.03)세;평균CRT위(619.06±335.07) μm;평균SFCT(271.24±106.61) μm.존재시망막출혈(SRH)、시망막층간적액(IRF)、시망막하액(SRF)、색소상피탈리(PED)자분별위4、2、13、15지근.PR조9례중,남성8례,녀성1례;평균년령(64.00±7.02)세;평균CRT위(509.67±255.21) μm;평균SFCT(271.24±106.61) μm.존재SRH、IRF、PED자분별위6、5、6、8지안.량조간성별、평균년령、평균CRT、평균SFCT비교,차이무통계학의의(P＞0.05).비교량조기선시SD-OCT도상특정각삼수여치료후BCVA적관계,병행logistic회귀분석.결과 치료후1、2、3、6개월환안평균BCVA분별위(38.46±19.81)、(40.04±20.80)、(42.96±21.63)、(43.77±20.91)개자모.치료후6개월,GR조、PR조평균CRT분별위(360.71±276.54)、(341.44±193.68) μm.량조평균CRT비교,차이무통계학의의(P＞0.05).GR조SFCT≥263 μm자11지안,점GR조환안적64.71％.PR조SFCT≥263 μm자2지안,점PR조환안적22..22％.량조간SFCT≥263 μm자구성비비교,차이유통계학의의[비치비(OR):0.052,95％가신간구(CI):0.005～0.533;P=0.013].Logistic회귀분석결과현시,치료전존재IRF(OR=9.375,95％CI 1.299～67.645;P=0.026)、SRH(OR=6.500,95％CI 1.094～38.633;P=0.040)자대치료반응차.결론 SFCT후자대치료민감;치료전존재IRF、SRH시영향치료후시력적위험인소.
    Objective To evaluate the spectral domain optical coherence tomography (SD-OCT) characteristics of polypoidal choroidal vasculopathy (PCV) and its correlation with the visual acuity after photodynamic therapy (PDT) combined with intravitreal ranibizumab.Methods Twenty-six eyes of 26 patients with PCV diagnosed by indocyanine green angiography (ICGA) were enrolled in this study.All the patients were examined for best corrected visual acuity (BCVA),slit lamp microscope,SD-OCT,fundus fluorescein angiography (FFA) and ICGA before and 1,3 months after treatment.The mean baseline BCVA was (31.46±16.87) letters,mean central retinal thickness (CRT) was (581.19±309.05) μm,and mean subfoveal choroidal thickness (SFCT) was (248.92±95.45) μm.Patients were divided into 2 groups according to the final visual improvement after 6 month of treatment:GR or sensitive Group (17 eyes) and PR or non-sensitive Group (9 eyes).GR group included 12 males and 5 females,with a mean age of (65.24± 7.03) years,a mean CRT of (619.06±335.07) μm and a mean SFCT of (271.24±±106.61) μm.There were 4 eyes with subretinal hemorrhage (SRH),2 eyes with interface retinal fluid (IRF),13 eyes with subretinal fluids (SRF) and 15 eyes with pigment epithelial detachment (PED).PR group included 8 males and 1female,with a mean age of (64.00±7.02) years,a mean CRT of (509.67±255.21) μm and a mean SFCT of (271.24 ± 106.61) μm.There were 6 eyes with subretinal hemorrhage (SRH),5 eyes with interface retinal fluid (IRF),6 eyes with subretinal fluids (SRF) and 8 eyes with pigment epithelial detachment (PED).The difference of sex,age,CRT and SFCT between these two groups was not significant (P＞ 0.05).The relationship of baseline SD-OCT and post-treatment BCVA was analyzed.Results On 1,2,3,6 months after treatment,the BCVA were (38.46±19.81),(40.04±20.80),(42.96±21.63),(43.77±20.91) letters respectively.On 6 months after treatment,the mean CRT in GR and PR group were (360.71±276.54),(341.44±193.68) μmrespectively (P＞0.05).64.71％ (11/17) eyes in GR group and 22.22％ (2/9) eyes in PR group had a SFCT thicker than 263μm.The difference was statistical significant between two groups [odds ratio (OR):0.052,95 ％ confidence interval (CI):0.005-0.533; P=0.013].Logistic regression analysis showed that existence of IRF (OR=9.375,95％ CI:1.299-67.645 ; P=0.026) or SRH (OR=6.500,95％CI:1.094-38.633 ; P=0.040) at baseline was negative prognostic factor to treatment.Conclusion Thick SFCT is a protective factor,however,existence of IRF or SRH at baseline is negative prognostic factor of final visual improvement.
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