玻璃体内注射贝伐单抗对DME患者视力、黄斑中心厚度和眼血流的影响

摘要

AIM: To investigate effects of intravitreal bevacizumab on ocular blood flow parameters in diabetic patients with macular edema.METHODS: This study included 21 eyes of 21 patients. Patients who had diffuse diabetic macular edema (DME), central macular thickness (CMT) >320μm and have no ischemic macular edema or other vascular retinal disease included to this study. rnAll patients underwent three ophthalmologic examinations before and at one day and at 4 weeks after bevacizumab 1.25mg/0.05 mL injection. Examinations including visual acuity (VA), easurement CMT by optical coherence tomography (OCT), peak systolic velocities (PSV) and end-diastolic velocities(EDV) of blood flows were measured by ultrasound imaging in the ophthalmic artery (OA), in the central retinal artery (CRA), in the nasal posterior ciliary artery (NPCA) and temporal posterior ciliary artery (TPCA). Resistive indices (RI) were automatically calculated by software of device. The velocities of blood flow before and one day after injections were compared. The values of patients before and 4 weeks after injections were compared for VA and CMT. RESULTS: Mean best-corrected visual acuity (BCVA) was 0.88±0.21 logarithm of the minimum angle of resolution (logMAR) before and after injection was 0.54±0.19 logMAR units (P 320μm,无缺血性黄斑水肿或其他血管性视网膜疾病.患者术前以及注射1.25mg/0.05mL贝伐单抗1d,4wk后接受三种眼科检查:视力(visual acuity,VA)检测、光学相干断层扫描(optical coherence tomography,OCT)测量CMT以及采用超声成像测量眼动脉(ophthalmic artery,OA)、视网膜中央动脉(central retinal artery,CRA)、鼻侧睫状后动脉(nasal posterior ciliary artery,NPCA)以及颞侧睫状后动脉(temporal posterior ciliary artery,TPCA)中的收缩期峰值血流速度(peak systolic velocities,PSV)和舒张末期血流速度(end-diastolic velocities,EDV).阻力指数(resistive indices,RI)由软件自动计算,注射前与注射后1d的血流速度进行了比较.患者术前和注射后4wk的VA和CMT值进行了比较.结果:注射前平均最佳矫正视力(best-corrected visual acuity,BCVA)为0.88±0.21logMAR,注射后为0.54±0.19logMAR(P<0.01).平均CMT由注射前440.57±54.58μm下降至250.33±31.12μm(-190.24±36.00μm).PSV、EDV和RI的变化并不显著.结论:贝伐单抗注射后视力显着改善,CMT降低,而PSV、EDV和RI在OA、CRA、TPCA和NPCA中没有显著变化.玻璃体内注射贝伐单抗注射液能改善VA和CMT,但对于糖尿病患者的OA、CRA、TPCA和NPCA的血流速度没有影响.