PDF(Pubmed)
Abstract：
OBJECTIVE: To determine whether intravitreal injection of recombinant tissue plasminogen activator (rTPA) is effective for the treatment of refractory diabetic macular edema (DME) in patients who already had posterior vitreous detachment (PVD).
METHODS: It is a retrospective chart review of the patients with refractory DME and PVD. The efficacy of intravitreal injection of rTPA was assessed based on the changes in central macular thickness (CMT) and best-corrected visual acuity (BCVA) in these patients.
RESULTS: Nine eyes of nine patients as the study group and 14 eyes of the 14 patients as the control group were examined. Before the injections, the mean CMT was 470.0± 107.6 in the study group, compared to 536.2± 150.5 in the control group, with no statistical significance (p=0.403). The statistical analysis revealed no significant differences in the mean changes in CMT from baseline to one and three months after injections between the study and control groups (p=0.439, p=0.781, respectively). Likewise, no statistically significant disparities were observed in the mean pre-injection BCVA between the study group (0.877± 0.349) and the control group (0.950± 0.300) (p=0.415). Additionally, after three months of injection, there were no significant changes in the mean BCVA of the study group (0.844± 0.304) and the control group (0.864± 0.253) (p=0.512).
CONCLUSIONS: This study showed that rTPA has no effect on changes in CMT and BCVA in patients who had refractory DME and PVD at the same time. This may suggest that the improvement in CMT in previous studies may be due to the induction of PVD.
METHODS: It is a retrospective chart review of the patients with refractory DME and PVD. The efficacy of intravitreal injection of rTPA was assessed based on the changes in central macular thickness (CMT) and best-corrected visual acuity (BCVA) in these patients.
RESULTS: Nine eyes of nine patients as the study group and 14 eyes of the 14 patients as the control group were examined. Before the injections, the mean CMT was 470.0± 107.6 in the study group, compared to 536.2± 150.5 in the control group, with no statistical significance (p=0.403). The statistical analysis revealed no significant differences in the mean changes in CMT from baseline to one and three months after injections between the study and control groups (p=0.439, p=0.781, respectively). Likewise, no statistically significant disparities were observed in the mean pre-injection BCVA between the study group (0.877± 0.349) and the control group (0.950± 0.300) (p=0.415). Additionally, after three months of injection, there were no significant changes in the mean BCVA of the study group (0.844± 0.304) and the control group (0.864± 0.253) (p=0.512).
CONCLUSIONS: This study showed that rTPA has no effect on changes in CMT and BCVA in patients who had refractory DME and PVD at the same time. This may suggest that the improvement in CMT in previous studies may be due to the induction of PVD.
摘要：
目的：确定玻璃体内注射重组组织型纤溶酶原激活剂（rTPA）是否有效治疗已经有玻璃体后脱离（PVD）的难治性糖尿病性黄斑水肿（DME）。
方法：这是难治性DME和PVD患者的回顾性分析。根据这些患者的中央黄斑厚度（CMT）和最佳矫正视力（BCVA）的变化评估玻璃体内注射rTPA的疗效。
结果：检查9例患者的9只眼作为研究组，14例患者的14只眼作为对照组。在注射之前,研究组平均CMT为470.0±107.6，与对照组的536.2±150.5相比，无统计学意义(p=0.403)。统计分析显示，研究组和对照组之间从基线到注射后1个月和3个月的CMT平均变化没有显着差异（分别为p=0.439，p=0.781）。同样，研究组(0.877±0.349)和对照组(0.950±0.300)的平均注射前BCVA无统计学差异(p=0.415).此外,注射三个月后，研究组（0.844±0.304）和对照组（0.864±0.253）的平均BCVA没有显着变化（p=0.512）。
结论：这项研究表明，rTPA对同时患有难治性DME和PVD的患者的CMT和BCVA的变化没有影响。这可能表明，在以前的研究中，CMT的改善可能是由于PVD的诱导。
方法：这是难治性DME和PVD患者的回顾性分析。根据这些患者的中央黄斑厚度（CMT）和最佳矫正视力（BCVA）的变化评估玻璃体内注射rTPA的疗效。
结果：检查9例患者的9只眼作为研究组，14例患者的14只眼作为对照组。在注射之前,研究组平均CMT为470.0±107.6，与对照组的536.2±150.5相比，无统计学意义(p=0.403)。统计分析显示，研究组和对照组之间从基线到注射后1个月和3个月的CMT平均变化没有显着差异（分别为p=0.439，p=0.781）。同样，研究组(0.877±0.349)和对照组(0.950±0.300)的平均注射前BCVA无统计学差异(p=0.415).此外,注射三个月后，研究组（0.844±0.304）和对照组（0.864±0.253）的平均BCVA没有显着变化（p=0.512）。
结论：这项研究表明，rTPA对同时患有难治性DME和PVD的患者的CMT和BCVA的变化没有影响。这可能表明，在以前的研究中，CMT的改善可能是由于PVD的诱导。
