| Objective:Optical coherence tomography(OCT)and optical coherence tomography angiography(OCTA)were used to observe the changes in the vascular density(VD)of retinal capillary plexus and the foveal avascular zone(FAZ)area in macular area after intravitreal injection of Anti-vascular endothelial growth factor(Anti-VEGF)for diabetic macular edema(DME),to evaluate the effect of Anti-VEGF therapy on retinal microcirculation in macular area and to explore the effect and the possible mechanism of Anti-VEGF therapy from the perspective of retinal microcirculation.Methods:A total of 36 patients with DME diagnosed in the ophthalmology clinic of the First Central Hospital of Baoding from March 2018 to June 2019 were collected.All patients in the study were treated with monthly intravitreal injection of Anti-vascular endothelial growth factor for three consecutive months,that is,0.05ml/0.5mg intravitreal injection of Conbercept Ophthalmic Injection(Conbercept,Chengdu Kanghong Biotech Ltd,Sichuan,NMPNS20130012),and all were followed up for three months.The best corrected visual acuity(BCVA),central retinal thickness(CRT),vessel density(VD)of the superficial retinal capillary plexus(SCP)and deep retinal capillary plexus(DCP),and foveal avascular zone(FAZ)area of SCP were measured before treatment and one month after each treatment.The above measurements enrolled before and after treatment were analyzed and compared.Results:1.The Log MAR BCVA before Anti-VEGF therapy was 0.62±0.039,and the Log MAR BCVA after three treatments were 0.42 ± 0.039,0.34 ± 0.039,and 0.29 ± 0.031,respectively.The Log MAR BCVA after treatment is significantly higher than before treatment,the difference was statistically significant(t1=10.771,P1<0.05;t2=13.117,P2<0.05;t3=16.257,P3<0.05).2.The CRT before Anti-VEGF therapy was(472.42 ± 9.68)μm,and the CRT after three treatments were(339.33 ± 6.73)μm,(320.89 ± 7.60)μm,(300.14 ± 5.60)μm,respectively.The CRT after treatment is significantly lower than before treatment,the difference was statistically significant(t1=16.357,P1<0.05;t2=13.274,P2<0.05;t3=17.948,P3<0.05).3.The VD of SCP before Anti-VEGF therapy was(44.27 ± 0.041)%,and the VD of SCP after three treatments were(44.28 ± 0.039)%,(44.32 ± 0.040)%,(44.32 ± 0.040)%,respectively.The VD of SCP were not significantly different before and after intravitreal injection(t1=0.053,P1>0.05;t2=-0.351,P2>0.05;t3=-0.310,P3>0.05).4.The VD of DCP before Anti-VEGF therapy was(52.96 ± 0.041)%,and the VD of DCP after three treatments were(52.94 ± 0.038)%,(52.87 ± 0.038)%,(52.87 ± 0.038)%,respectively.The VD of DCP were not significantly different before and after intravitreal injection(t1=0.174,P1>0.05;t2=0.706,P2>0.05;t3=0.664,P3>0.05).5.The FAZ area of SCP before Anti-VEGF therapy was(0.56 ± 0.084)mm2,and the FAZ area of SCP after three treatments were(0.56 ± 0.082)mm2,(0.56 ± 0.084)mm2,(0.56 ± 0.080)mm2,respectively.The FAZ area of SCP were not significantly different before and after intravitreal injection(t1=0.531,P1>0.05;t2=0.846,P2>0.05;t3=0.495,P3>0.05).Conclusion:1.There were no significant changes in the vessel density of superficial retinal capillary plexus,the vessel density of deep retinal capillary plexus and no significant change the foveal avascular zone area in macular area of patients with diabetic macular edema after monthly intravitreal injection of Conbercept for three consecutive months.Short-term Anti-VEGF treatment did not cause further damage to the retinal microcirculation structure in macular area of patients with diabetic macular edema.2.The best corrected visual acuity and central retinal thickness of patients with diabetic macular edema were significantly improved,while the retinal microcirculation structure in macular area of patients with diabetic macular edema were not significantly improved after monthly intravitreal injection of Conbercept for three consecutive months.Short-term Anti-VEGF therapy has no obvious effect on repairing the damaged retinal microcirculation structure in patients with diabetic macular edema. |
PDF Full Text Request