Short-Term Response of Diabetic Macular Edema to Intravitreal Bevacizumab: An Optical Coherence Tomographic Patterns Analysis

以玻璃體內注射癌思停治療不同眼底光學同調斷層掃瞄型態之糖尿病黃斑部水腫的短期反應

王嘉康(Jia-Kang Wang)

《中華民國眼科醫學會雜誌》 50卷2期 (2011/06) Pp. 283-290

https://doi.org/10.30048/ACTASOS.201106.0009

摘要

目的：在於探討對於糖尿病黃斑部水腫，其各種眼底光學同調斷層掃描之型態，以玻璃體內注射癌思停後之短期成效。方法：這是一個回溯性、比較性之研究。自2010年1月至2010年9月，收集糖尿病黃斑部水腫患者，到院前並無任何治療，眼內注射1.25mg癌思停一次，皆以眼底光學同調斷層掃描，共分三組，第一組為廣泛性黃斑部增厚（30隻眼），第二組為囊狀黃斑部水腫（50隻眼），第三組為漿液性黃斑部剝離（30隻眼）。測量注射一個月後，中央窩厚度、及中央黃斑部體積之變化，並記錄併發症之發生，組內及組間之差異分別以方法統計之。結果：中央窩厚度、及中央黃斑部體積在注射1個月後第二及第三組皆顯著降低（p＜0.05），但第一組並無顯著降低（p＞0.05）。注射前後，中央窩厚度及中央黃斑部體積之減少量，第三組比第二組顯著較多（p＜0.05）。結論：糖尿病患者有漿液性黃斑部剝離，在玻璃體內注射癌思停後，短期內比囊狀黃斑部水腫效果來的好，玻璃體內注射癌思停對廣泛性黃斑部增厚之糖尿病患無效。

並列摘要

Purpose: To investigate the short-term response to intravitreal bevacizumab (IVB) in patients with various optical coherence tomographic patterns of diabetic macular edema.Methods: This is a retrospective and comparative study. From January 2010 to September 2010, patients with diabetic macular edema but without prior macular laser or any intervention and receiving single IVB of 1.25 mg were enrolled. The eyes examined by spectral-domain optical coherence tomography (OCT) were divided into three groups: Group 1, patients with diffuse macular thickening (30 eyes); Group 2, patients with cystoid macular edema (50 eyes); and Group 3, patients with serous macular detachment (30 eyes). Primary outcome measures included change in central foveal thickness (CFT) of 1 mm and central macular volume (CMV) of 5 mm in diameter by OCT one month after injections. Complications after injections were recorded. The intra-group difference was compared with Wilcoxon sign-rank test, and the inter-group difference was compared with Wilcoxon rank-sum test. Results: Both CMV and CFT reduced significantly one month after injections in Groups 2 and 3 (p ＜ 0.05), but there was no significant change in Group 1 (p ＞ 0.05). Reduction of CFT and CMV were significantly larger in Group 3 than in Groups 1 and 2 (p ＜ 0.05) at one month.Conclusions: Diabetic eyes with serous macular detachment showed better tomographic response to IVB than cases with cystoid macular edema in short-term follow-up. Bevacizumab treatment was not effective in treating diffuse macular thickening subtype in diabetic patients.

並列關鍵字

Intravitreal injection ； bevacizumab ； diabetic macular edema ； optical coherence tomography