The visual acuity changes in patients with different patterns of optical coherence tomography of diabetic macular edema after intravitreal ranibizumab injection and/or laser photocoagulation
Xiangning Wang, Shu-ting Li, Xin-hua Du, Yong-dong Chen
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Abstract
Objective
To observe the visual acuity change in patients with different patterns of optical coherence tomography (OCT) of diabetic macular edema (DME) after intravitreal ranibizumab injection and/or laser photocoagulation.
Methods
A retrospective observational case series. Seventy patients (99 eyes) with DME were enrolled. Best-corrected visual acuity (BCVA) was evaluated using the international vision test chart, and then convert the result to the logarithm of the minimum angle of resolution (logMAR). According to the morphological characteristics of OCT, the DME was divided into 3 patterns, including diffuse macular edema (DRT), cystoid macular edema (CME) and serous neuroepithelial layer detachment. The average follow-up was (80.43±74.89) days. The patients were divided into 3 groups according to the different treatments, including intravitreal ranibizumab injection group (group A, 21 patients, 25 eyes), intravitreal ranibizumab injection and laser photocoagulation group (group B, 23 patients, 26 eyes), laser photocoagulation group (group C, 26 patients, 48 eyes). The changes of absolute BCVA (ABCVA) and improved visual acuity were compared between different treatment groups and different OCT patterns. ABCVA = logMAR BCVA before treatment-logMAR BCVA after treatment. Improvement more than 0.3 of logMAR value was considered as improved visual acuity.
Results
There was no significant difference in ABCVA between different treatment groups (F=0.050,P>0.05). The improved visual acuity in group A and B were great than group C (χ2=5.645, 6.301;P 0.05). Improved visual acuity of DRT and CME eyes were higher in group ABP<0.05).
Conclusions
There is no obvious change of visual acuity in patients with different OCT patterns of DME after the same treatment by intravitreal ranibizumab injection and/or laser photocoagulation. The improved visual acuity is not consistent in same OCT patterns after different treatment.
Key words:
Diabetic retinopathy/therapy; Macular edema /therapy; Angiogenesis inhibitors/ therapeutic use; Antibodies, monoclonal/therapeutic use; Laser coagulation; Tomography, optical coherence
目的观察不同光学相干断层扫描（OCT）模式糖尿病黄斑水肿（DME）患者玻璃体内注射和/或激光凝固后的视力变化。方法回顾性观察病例系列。纳入DME患者70例（99眼）。使用国际视力测试表评估最佳矫正视力（BCVA），然后将结果转换为最小分辨角（logMAR）的对数。根据OCT的形态学特征，将DME分为3种类型，包括弥漫性黄斑水肿（DRT）、囊状黄斑水肿（CME）和浆液性神经上皮层脱离。平均随访时间为（80.43±74.89）天。根据不同的治疗方法将患者分为3组，分别为玻璃体内注射雷尼珠单抗组（A组，21例，25眼）、玻璃体内注射并激光光凝组（B组，23例，26眼）、激光光凝治疗组（C组，26例，48眼）。比较不同治疗组和不同OCT模式下绝对BCVA（ABCVA）的变化和视力的改善。ABCVA=治疗前logMAR BCVA治疗后logMAR BC VA。logMAR值的改善超过0.3被认为是视力的改善。结果不同治疗组间ABCVA差异无统计学意义（F=0.050，P>0.05），A、B组视力改善程度明显高于C组（χ2=5.645，6.301；P<0.05），DRT和CME眼视力改善程度均高于ABP组（P<0.05）通过玻璃体内注射雷珠单抗和/或激光光凝进行治疗。不同治疗后，相同OCT模式下的视力改善并不一致。关键词：糖尿病视网膜病变/治疗；黄斑水肿/治疗；血管生成抑制剂/治疗用途；单克隆抗体/治疗用途；激光凝固；层析成像，光学相干
期刊介绍：
Chinese Journal of Ocular Fundus Diseases is the only scientific journal in my country that focuses on reporting fundus diseases. Its purpose is to combine clinical and basic research, and to give equal importance to improvement and popularization. It comprehensively reflects the leading clinical and basic research results of fundus disease disciplines in my country; cultivates professional talents in fundus disease, promotes the development of fundus disease disciplines in my country; and promotes academic exchanges on fundus disease at home and abroad. The coverage includes clinical and basic research results of posterior segment diseases such as retina, uveal tract, vitreous body, visual pathway, and internal eye diseases related to systemic diseases. The readers are medical workers and researchers related to clinical and basic research of fundus diseases. According to the journal retrieval report of the Chinese Institute of Scientific and Technological Information, the comprehensive ranking impact factor and total citation frequency of the Chinese Journal of Ocular Fundus Diseases have been among the best in the disciplines of ophthalmology, otolaryngology, and ophthalmology in my country for many years. The papers published have been included in many important databases at home and abroad, such as Scopus, Peking University Core, and China Science Citation Database (CSCD).
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