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Abstract：
OBJECTIVE: To evaluate the efficacy of retinal laser photocoagulation and intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) for hemorrhagic retinal arterial macroaneurysm (RAM).
METHODS: This was a retrospective clinical study. Patients with hemorrhagic RAM were divided into 4 groups defined by different treatments: a retinal laser photocoagulation therapy monotherapy group, an anti-VEGF intravitreal injection monotherapy group, a laser and anti-VEGF combination therapy group, and an observation group. Visual acuity (VA), central macular thickness (CMT), and retinal hemorrhage area (RHA) were collected.
RESULTS: Forty-seven eyes of 47 patients were enrolled. VA improved and had a significant difference between baseline and final in each treatment group (logMAR; laser group: 1.90±0.53 vs 1.05±0.63, P<0.001; anti-VEGF group: 1.75±0.63 vs 1.12±0.54, P=0.009; combination group: 1.76±0.38 vs 1.01±0.52, P<0.001); however, VA decreased and had no significant difference in observation group (1.63±0.51 vs 1.76±0.61, P=0.660). CMT decreased and had a significant difference between baseline and final in each group (laser group: 815.16±310.83 vs 252.05±83.90 µm, P<0.001; anti-VEGF group: 725.00±290.79 vs 203.56±69.89 µm, P=0.001; combination group: 595.50±186.51 vs 253.13±55.06 µm, P=0.001; observation group: 758.88±195.65 vs 267.00±120.90 µm, P=0.001). RHA were 28.99±28.15, 25.94±11.58, 19.64±8.97, and 27.45±13.76 mm2 in laser group, anti-VEGF group, combination group and observation group, respectively. RHA was statistically correlated with final VA (P=0.032) in the observation group.
CONCLUSIONS: Both laser and anti-VEGF treatments are effective for hemorrhagic RAM. Combination therapy reduces the number of injections of anti-VEGF. RHA is a visual prognosis predictor in the natural history of hemorrhagic RAM.
METHODS: This was a retrospective clinical study. Patients with hemorrhagic RAM were divided into 4 groups defined by different treatments: a retinal laser photocoagulation therapy monotherapy group, an anti-VEGF intravitreal injection monotherapy group, a laser and anti-VEGF combination therapy group, and an observation group. Visual acuity (VA), central macular thickness (CMT), and retinal hemorrhage area (RHA) were collected.
RESULTS: Forty-seven eyes of 47 patients were enrolled. VA improved and had a significant difference between baseline and final in each treatment group (logMAR; laser group: 1.90±0.53 vs 1.05±0.63, P<0.001; anti-VEGF group: 1.75±0.63 vs 1.12±0.54, P=0.009; combination group: 1.76±0.38 vs 1.01±0.52, P<0.001); however, VA decreased and had no significant difference in observation group (1.63±0.51 vs 1.76±0.61, P=0.660). CMT decreased and had a significant difference between baseline and final in each group (laser group: 815.16±310.83 vs 252.05±83.90 µm, P<0.001; anti-VEGF group: 725.00±290.79 vs 203.56±69.89 µm, P=0.001; combination group: 595.50±186.51 vs 253.13±55.06 µm, P=0.001; observation group: 758.88±195.65 vs 267.00±120.90 µm, P=0.001). RHA were 28.99±28.15, 25.94±11.58, 19.64±8.97, and 27.45±13.76 mm2 in laser group, anti-VEGF group, combination group and observation group, respectively. RHA was statistically correlated with final VA (P=0.032) in the observation group.
CONCLUSIONS: Both laser and anti-VEGF treatments are effective for hemorrhagic RAM. Combination therapy reduces the number of injections of anti-VEGF. RHA is a visual prognosis predictor in the natural history of hemorrhagic RAM.
摘要：
目的：评价视网膜激光光凝联合玻璃体腔注射抗血管内皮生长因子(VEGF)治疗出血性视网膜大动脉瘤(RAM)的疗效。
方法：这是一项回顾性临床研究。根据不同的治疗方法将出血性RAM患者分为4组：视网膜激光光凝治疗单药治疗组，抗VEGF玻璃体内注射单药治疗组，激光和抗VEGF联合治疗组，和一个观察组。视敏度（VA），黄斑中心厚度(CMT),收集视网膜出血面积(RHA)。
结果：纳入47例患者的47只眼。每个治疗组的VA改善，基线和最终之间存在显着差异（logMAR；激光组：1.90±0.53vs1.05±0.63，P<0.001；抗VEGF组：1.75±0.63vs1.12±0.54，P=0.009；联合组：1.76±0.38vs1.01±0.52，P<0.001）；但是，观察组VA下降,差异无统计学意义(1.63±0.51vs1.76±0.61,P=0.660)。CMT下降，每组基线和最终之间存在显着差异（激光组：815.16±310.83vs252.05±83.90µm，P<0.001；抗VEGF组：725.00±290.79vs203.56±69.89µm，P=0.001；联合组：595.50±186.51vs253.13±55.06µm，P=0.001；观察组：758.88±195.65vs267.00±120.90µm，P=0.001)。激光组RHA分别为28.99±28.15、25.94±11.58、19.64±8.97、27.45±13.76mm2,抗VEGF组，联合组和观察组,分别。观察组RHA与最终VA有统计学相关性(P=0.032)。
结论：激光和抗VEGF治疗对出血性RAM均有效。联合治疗减少了抗VEGF的注射次数。RHA是出血性RAM自然史的视觉预后预测因子。
方法：这是一项回顾性临床研究。根据不同的治疗方法将出血性RAM患者分为4组：视网膜激光光凝治疗单药治疗组，抗VEGF玻璃体内注射单药治疗组，激光和抗VEGF联合治疗组，和一个观察组。视敏度（VA），黄斑中心厚度(CMT),收集视网膜出血面积(RHA)。
结果：纳入47例患者的47只眼。每个治疗组的VA改善，基线和最终之间存在显着差异（logMAR；激光组：1.90±0.53vs1.05±0.63，P<0.001；抗VEGF组：1.75±0.63vs1.12±0.54，P=0.009；联合组：1.76±0.38vs1.01±0.52，P<0.001）；但是，观察组VA下降,差异无统计学意义(1.63±0.51vs1.76±0.61,P=0.660)。CMT下降，每组基线和最终之间存在显着差异（激光组：815.16±310.83vs252.05±83.90µm，P<0.001；抗VEGF组：725.00±290.79vs203.56±69.89µm，P=0.001；联合组：595.50±186.51vs253.13±55.06µm，P=0.001；观察组：758.88±195.65vs267.00±120.90µm，P=0.001)。激光组RHA分别为28.99±28.15、25.94±11.58、19.64±8.97、27.45±13.76mm2,抗VEGF组，联合组和观察组,分别。观察组RHA与最终VA有统计学相关性(P=0.032)。
结论：激光和抗VEGF治疗对出血性RAM均有效。联合治疗减少了抗VEGF的注射次数。RHA是出血性RAM自然史的视觉预后预测因子。
