不同贝伐单抗暴露的糖尿病视网膜病变患者的乳头周围OCTA指标：一项横断面研究

IF 2.6 3区医学 Q2 ONCOLOGY

Photodiagnosis and Photodynamic Therapy Pub Date : 2025-09-10 DOI:10.1016/j.pdpdt.2025.105217

Farideh Mousavi , Salar Nikmanesh , Amin Arasteh , Amir Tarkavani , Amir Eftekhari Milani , Peyman Ghodraty

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引用次数: 0

摘要

目的：通过光学相干断层血管造影（OCTA）比较不同次数玻璃体内注射贝伐单抗（IVB）的糖尿病视网膜病变（DR）患者与非糖尿病对照者视神经头（ONH）微血管和视网膜神经纤维层（RNFL）厚度。方法：对145例患者246只眼进行横断面研究，分为4组：a组：健康对照（53只眼）；B组：无IVB治疗的DR（103眼）；C组：首次注射IVB后1周DR（42眼）；D组：DR组，过去一年至少接受9次IVB注射（48只眼）。所有纳入的眼均采用AngioVue系统行ONH OCTA，并评估乳头周围血管密度（VD）和RNFL厚度。结果：男性60例，女性85例，中位年龄64.0岁。这些小组在年龄和性别方面没有差别。C组和D组乳头周围VD明显低于对照组（分别为49.6%和48.9% vs. 53.0%）。结论：糖尿病视网膜病变和抗vegf治疗可以降低乳头周围VD，这种VD似乎主要发生在鼻部，在dr的晚期变得明显，但IVB注射的频率可能不会影响乳头周围微血管。

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Peripapillary OCTA metrics in diabetic retinopathy patients with varying bevacizumab exposure: A cross-sectional study

Objective

To compare optic nerve head (ONH) microvasculature and retinal nerve fiber layer (RNFL) thickness of diabetic retinopathy (DR) patients with varying numbers of intravitreal bevacizumab (IVB) injections to non-diabetic controls via optical coherence tomography angiography (OCTA).

Methods

It is a cross-sectional study of 246 eyes of 145 patients in 4 groups: group A: healthy control subjects (53 eyes); group B: DR without any IVB treatment (103 eyes); group C: DR one week after their first IVB injection (42 eyes); and group D: DR which received at least 9 IVB injections for the past year (48 eyes). All the included eyes underwent ONH OCTA using the AngioVue system, and the peripapillary vessel density (VD) and RNFL thickness were evaluated.

Results

60 males and 85 females with a median age of 64.0 years were included in the study. The groups were not different in terms of age or sex. Groups C and D presented significantly lower peripapillary VDs than the controls (49.6 % and 48.9 % vs. 53.0 %, respectively, p < 0.001). The peripapillary VD was lower in treatment-naïve DR cases than in controls, but this difference was not statistically significant (51.4 % vs. 53.0 %). The whole-image VD was lower in group B than in group A (47.8 % vs. 49.6 %, p = 0.007); however, when the comparison was limited to mild to moderate DRs, the difference was insignificant (p = 0.949). Although the peripapillary VD was lower in group D cases than in group B cases (48.9 % vs. 51.4 %, p = 0.020), the subgroup analysis of severe NPDR patients in groups B, C, and D revealed no significant differences among the three groups in terms of peripapillary VD. However, the nasal segment VD was significantly lower in IVB-treated cases than in treatment-naïve cases. In addition, among treatment-naïve cases, the PDR cases had lower nasal VD than the mild NPDR cases. The RNFL thickness was not significantly different among the four groups (p = 0.256).

Conclusion

Diabetic retinopathy and anti-VEGF treatment could reduce the peripapillary VD, which seems to happen primarily in the nasal segment and becomes evident in more advanced stages of DR. However, the frequency of IVB injections might not affect the peripapillary microvasculature.

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来源期刊

Photodiagnosis and Photodynamic Therapy ONCOLOGY-

CiteScore

5.80

自引率

24.20%

发文量

509

审稿时长

50 days

期刊介绍： Photodiagnosis and Photodynamic Therapy is an international journal for the dissemination of scientific knowledge and clinical developments of Photodiagnosis and Photodynamic Therapy in all medical specialties. The journal publishes original articles, review articles, case presentations, "how-to-do-it" articles, Letters to the Editor, short communications and relevant images with short descriptions. All submitted material is subject to a strict peer-review process.