计算机辅助光学相干断层扫描探究病理性近视继发的脉络膜新生血管的形态学改变

Objective: To explore the morphological changes of the retina and myopic choroidal neovascularization secondary to pathologic myopia (PM - CNV) after intravitreal injection of ranibizumab (IVR) using computer - assisted optical coherence tomography (OCT). Methods: 15 patients (15 eyes) with PM - CNV received IVR treatment for 3 months according to the 1 + PRN regimen. The best corrected visual acuity (BCVA) of the patients before and after treatment was measured. Various morphological parameters of the retina and PM - CNV were obtained with the help of computer - assisted OCT, and the changes of various parameters before and after treatment were statistically analyzed using SPSS 22.0 software. Results: The visual acuity of the eyes improved after treatment (P = 0.005). Except that the difference in the average thickness of the nasal quadrant of the inner ring before and after treatment was not statistically significant (P = 0.066), the decreases in the average thickness of the fovea and the superior, inferior, and temporal sides of the inner ring were statistically significant (P = 0.001, 0.027, 0.008, 0.031). The central choroidal thickness (CCT) also decreased after treatment (P = 0.007). The differences in the width, height, area, volume, and mean pixel intensity (MPI) of PM - CNV before and after treatment were statistically significant (P = 0.003, 0.012, 0.014, 0.022, 0.007). Conclusion: After patients received IVR treatment for 3 months according to the 1 + PRN regimen, the retinal thickness in the macular area decreased, the CNV itself shrank, and the exudative edema between them decreased.

目的:利用计算机辅助光学相干断层扫描(optical coherence tomographic,OCT)探究病理性近视继发的脉络膜新生血管(myopic choroidal neovascularization secondary to pathologic myopia,PM-CNV)在接受玻璃体腔注射雷珠单抗(intravitreal ranibizumab,IVR)治疗后,视网膜及PM-CNV的形态学改变。方法:15例PM-CNV患者(15只眼)按1+PRN方案接受IVR治疗3个月,测量患者治疗前后最佳矫正视力(best corrected visual acuity,BCVA),借助计算机辅助OCT得出视网膜及PM-CNV的各项形态学参数,使用SPSS 22.0软件统计分析治疗前后各项参数的变化。结果:治疗后眼视力提高(P=0.005),除内环鼻侧象限平均厚度治疗前后差异无统计学意义(P=0.066)外,中心凹及内环的上、下、颞侧平均厚度的下降具有统计学差异(P=0.001、0.027、0.008、0.031)。中心脉络膜厚度(central choroidal thickness,CCT)在治疗后也有所降低(P=0.007)。PM-CNV的宽度、高度、面积、体积及平均像素强度(mean pixel intensity,MPI)在治疗前后的差异具有统计学意义(P=0.003、0.012、0.014、0.022、0.007)。结论:患者在按照1+PRN方案接受IVR治疗3个月后,黄斑区视网膜厚度降低,CNV本身缩小,其间的渗出水肿减少。