■评估糖尿病性黄斑水肿(DME)的不同光学相干断层扫描(OCT)模式对玻璃体内注射治疗的反应。
■在这次回顾中,比较,多中心研究,以前未经治疗的DME患者,在3个月的负荷剂量后接受玻璃体内雷珠单抗(IVR)或阿柏西普(IVA)和/或类固醇治疗的人,并在MARMASIA研究组进行了12个月的随访。根据OCT特征,DME的形态模式分为四组:弥漫性/自发性水肿(第1组),囊样水肿(第2组),弥漫性/自发性水肿+视网膜下液(SRF)(第3组),囊样水肿+SRF(第4组)。比较了DME组之间在第3、6和12个月时的中央黄斑厚度(CMT)和最佳矫正视力(BCVA)的变化以及第12个月时的注射次数。
■299例患者的455只眼纳入研究。第1、2、3和4组的平均基线BCVA[最小分辨角对数(logMAR)]分别为0.54±0.24、0.52±0.25、0.55±0.23和0.57±0.27。两组之间的基线平均BCVA之间没有显着差异(p=.35)。第1组的平均BCVA显着改善为0,47±0,33,第2组的0,42±0,33,第3组的0,47±0,31,第12个月的0,45±0,43。在第12个月时,两组之间的BCVA变化没有显着差异(p=0.71)。第1、2、3和4组的平均基线CMT分别为387、19±128、19、447、02±132、39、449、12±109、24和544、19±178、61。在基线,第4组的平均CMT显著高于其他组(p=.000).在第12个月,四组的平均CMT分别显着降低至325,16±97,55,334,94±115,99,324,33±79,20和332,08±150,40(p>.05)。两组在第12个月时的平均CMT没有显着差异(p=.835)。在第12个月时,第4组的CMT变化显着高于其他组(p=.000)。第12个月时玻璃体内注射抗VEGF的平均次数在第1组中为4.51±1.57,在第2组中为4.63±1.54,在第3组中为4.88±1.38,在第4组中为5.07±1.49。组1和组2中抗VEGF注射的平均次数显著低于组4(p=0.014和p=0.017)。
■在现实生活中,在12个月时,DME组之间在视觉改善方面没有显著差异.然而,第4组的解剖学改善优于其他DME组.
UNASSIGNED: To evaluate the responses of different optical coherence tomography (OCT) patterns of diabetic macular edema (DME) to intravitreal injection therapy.
UNASSIGNED: In this retrospective, comparative, and multicenter study, patients who had previously untreated DME, who received intravitreal ranibizumab (IVR) or aflibercept (IVA) and/or steroid treatment with the pro re nata (PRN) treatment regimen after a 3-month loading dose, and had a 12-month follow-up in the MARMASIA Study Group were included. Morphological patterns of DME were divided into four groups based on OCT features diffuse/spongious edema (Group 1), cystoid edema (Group 2), diffuse/spongious edema+subretinal fluid (SRF) (Group 3), and cystoid edema+SRF (Group 4). Changes in central macular thickness (CMT) and best-corrected visual acuity (BCVA) at months 3, 6, and 12, and the number of injections at month 12 were compared between the DME groups.
UNASSIGNED: 455 eyes of 299 patients were included in the study. The mean baseline BCVAs [Logarithm of the Minimum Angle of Resolution (logMAR)] in groups 1, 2, 3, and 4 were 0.54 ± 0.24, 0.52 ± 0.25, 0.55 ± 0.23, and 0.57 ± 0.27, respectively. There was no significant difference between the baseline mean BCVAs between the groups (p = .35). The mean BCVAs were significantly improved to 0,47 ± 0,33 in group 1, 0,42 ± 0,33 in group 2, 0,47 ± 0,31 in group 3, and 0,45 ± 0,43 at month 12. There was no significant difference between the groups in terms of BCVA change at month 12 (p = .71). The mean baseline CMTs in groups 1, 2, 3, and 4 were 387,19 ± 128,19, 447,02 ± 132,39, 449,12 ± 109,24, and 544,19 ± 178,61, respectively. At baseline, the mean CMT was significantly higher in Group 4 than in the other groups (p = .000). The mean CMTs were significantly decreased to 325,16 ± 97,55, 334,94 ± 115,99, 324,33 ± 79,20, and 332,08 ± 150,40 in four groups at month 12 respectively (p > .05). The groups had no significant difference in mean CMT at month 12 (p = .835). The change in CMT was significantly higher in Group 4 than in the other groups at month 12 (p = .000). The mean number of intravitreal anti-VEGF injections at month 12 was 4.51 ± 1.57 in Group 1, 4.63 ± 1.54 in Group 2, 4.88 ± 1.38 in Group 3, and 5.07 ± 1.49 in Group 4. The mean number of anti-VEGF injections in Group 1 and Group 2 was significantly lower than in Group 4 (p = 0,014 and p = 0,017).
UNASSIGNED: In real life, there was no significant difference between the DME groups in terms of visual improvement at month 12. However, better anatomical improvement was achieved in Group 4 than in the other DME groups.