| Objective: To observe the changes of retinal morphology and visual function in macular center before and after intravitreal injection of vascular endothelial growth factor(VEGF)into idiopathic choroidal neovascularization(ICNV).Methods:A retrospective analysis of 21 cases and 21 eyes of patients diagnosed with ICNV at the Second Hospital of Hebei Medical University from February 2019 to December 2019 was performed with intravitreal injection of anti-VEGF drugs.By observing the location of CNV lesions,they were grouped into the juxta foveal group(n = 10)and the subfoveal group(n=11).Based on the retinal fluid,they were divided into subretinal fluid(SRF)(n=12),Intraretinal fluid(IRF)group(n=9);the maximum linear width(GLD)of CNV lesions measured by OCT divided the patients into two groups,group A patients had GLD> 800 ?m(n= 8),GLD of patients in group B was less than 800?m(n=13).Optical coherence tomographic(OCT)was used to observe and measure the central retinal thickness(CRT)of the macular center depression and the maximum linear width(GLD)of CNV lesions before,1 and 3 months after operation,using MP-3 Microperimetry-3(MP-3)observes the average retinal light sensitivity(MS)and fixation of the patient within 12 ° of the macular fovea,and compares the fixation stability rate and central fixation of each group Rate and improvement of MS.Correlation analysis between CRT,GLD and MS was performed at the same time.Results:1.The central fixation rate of the eyes in juxta foveal group before surgery was better than that in the subfoveal group,and the difference was statistically significant(?~2 = 5.743,P <0.05).The improvement of fixation rate and central fixation rate in the juxta foveal group at 1 and 3 months after operation were better than those in the subfoveal group.Compared with before surgery,the MS in the juxta foveal group increased to(24.10 ± 2.4)dB at 1 month after surgery,and the difference was statistically significant(t =-3.171,P<0.05);the MS in the subfoveal group increased to(25.0 ± 0.83)dB,the difference was statistically significant(t =-2.809,P<0.05).At 3 months after operation,MS in the juxta foveal group increased to(25.70 ± 1.02)dB,and the difference was statistically significant(t=-5.287,P<0.05);MS in the subfoveal group increased to(25.73±1.61)dB.The difference was statistically significant(t =-3.769,P<0.05).The improvement of MS in the juxta foveal group at 1 and 3 months after operation was greater than that of the juxta foveal group.In the juxta foveal group,there was a strong negative correlation between MS and CRT in the first and third months after surgery(r =-0.691,-0.688;P <0.05);in the third month after operation,MS and GLD showed a strong negative correlation.(r =-0.626;P <0.05).Before and after surgery,in the first and third months after surgery,MS and CRT(r=0.415,-0.516,0.087,P >0.05),MS and GLD(r=-0.555,-0.140,-0.155,P> 0.05)have no significant correlation;2.The preoperative rate of fixation in the eyes of IRF group was higher than that of SRF group(X~2=8.867,P<0.05),and the difference was statistically significant.Compared with before surgery,the rate of fixation in the eyes of the SRF group after treatment increased compared with that before surgery,and the difference was statistically significant(?~2=13.795,P<0.05).The improvement rate of fixation stability in the SRF group at 1 and 3 months after operation was better than that of the IRF group compared with that before operation.Compared with preoperative eyes,ICNV patients in IRF group had MS increased at 1 and 3 months(P<0.05),and the changes were statistically significant.The increase of MS in the SRF group was greater than that in the IRF group at 1 and 3 months after surgery.There was no significant correlation between MS and CRT in the IRF group before and 3 months after surgery(r=0.025,-0.577,P> 0.05),and there was a strong negative correlation between MS and CRT at 1 month after surgery(r=-0.814;P<0.05);there was no significant correlation between MS and GLD before and 1 and 3 months after surgery(r =-0.148,-0.404,-0.252,P> 0.05).There was a strong negative correlation between MS and CRT in the SRF group before,1 and 3 months after operation(r=-0.619,-0.86,-0.739;P<0.05).There was no significant correlation between MS and GLD before and 1 month after surgery(r =-0.473,-0.548,P>0.05);MS and CRT showed a strong negative correlation at 3 months after surgery(r =-0.646;P< 0.05);3.According to GLD grouping,the improvement of the fixation stability rate of group A at 1 and 3 months after operation was better than that of group B compared with before operation,and before and at 1 and 3 months after operation There were no significant differences in central fixation rates.Retinal sensitivity was higher than that before surgery.At 1 month after operation,MS in group A increased to(24.59 ± 1.81)dB,the difference was statistically significant(t=-3.944,P<0.05);MS in group B increased to(24.43±1.77)dB,the difference was not statistically significant(t =-3.464,P > 0.05).At 3 months after operation,MS in group A increased to(25.75±1.47)dB,and the difference was statistically significant(t =-5.913,P <0.05);MS in group B increased to(25.53±0.29)dB,and there was no statistical difference.Significance(t =-2.074,P>0.05).The increase of MS in group A was higher than that in group B at 1 and 3 months after operation.There was no significant correlation between MS and CRT,MS and GLD before operation in group A(r=-0.299,-0.416,P>0.05).At 1 month after operation,MS was strongly negatively correlated with CRT,MS and GLD(r =-0.687,-0.574;P<0.05);3 months after operation,MS and CRT,MS and GLD were strongly negatively correlated(r =-0.643,-0.673;P<0.05).Conclusions:1.Intravitreal injection of anti-VEGF drugs has a reliable effect on macular structure and visual function in patients with ICNV,especially for patients with CNV lesions located in the juxta foveal,retinal effusion being subretinal fluid,or relatively large GLD.The postoperative improvement was significant,but the central fixation rate was not significantly improved.2.The changes of macular morphology and visual function after intravitreal injection of anti-VEGF drugs in ICNV patients were not synchronized on between the macular morphology and visual function after the surgery. |
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