| Purpose:Used of Optical coherence tomography angiography(OCTA)to quantitative assessment of vscular changes of the clinical efficacy of intravitreal Conbercept(IVC)in the treatment of diabetic macular edema(DME).Quantitative analysis of Foveal Avascular Zone(FAZ)and superficial vascular density in patients with after IVC was performed.The circulatory changes of the microvascular in the fovea of the DME patients were followed to guide the follow-up treatment of DME patients.Method:1.A retrospective case-control study.A total of 35 DME patients 35 eyes who were seen in Tianjin Eye Hospital from October 2016 to December 2017 were included in the study,25male(25)eyes,10 females(10 eyes),patients with DME were informed of the purpose and risk of the injection before IVC.2.The follow-up review of patients with DME after IVC at 1 week,1 month,and every other month during the follow-up period.During the follow-up period,comparing the central retina thickness(CRT)or the best corrected visual acuity(BCVA)changes before and after the injection to determine whether Inject again or not.The BCVA,CRT,and the foveal Avascular Zone(FAZ)in OCTA 3mm x 3mm model were observed and recorded at 1 month,3 months,and 6 months after IVC.3.Apply SPSS 23.0 software for statistical analysis of all data.After normality test,the measurement data were expressed as mean±standard deviation.Subjects' BCVA,CRT,FAZ area and mean vascular density were compared by t-test.The difference was statistically significant at P<0.05;n(%)means that multivariate analysis of variance,P <0.05 for the difference was statistically significant.Result:1.Preoperative basic conditions.Thirty-five patients 35 eyes of the DME group included in the study,including 25 male 25 eyes,10 females 10 eyes,aged 30 to 67 years old,mean age(48.9±10.6)years old,and disease duration(F=0.37,P=0.86),history of hypertension(F=0.81,P=0.52),history of retinal laser photocoagulation(F=1.14,P=0.36),intraocular pressure(IOP)(F=0.86,P= 0.52).The difference was not statistically significant.(all P > 0.05).2.LogMAR BCVA,CRT,FAZ?VD The average LogMAR BCVA,CRT,FAZ and VD at 1 month,3 months,and 6 months after DME were recorded and compared with the corresponding observations before IVC.The average LogMAR BCVA at 1,3 and 6 after IVC was significantly higher than before IVC,and the differences were statistically significant(t=12.821,20.515,20.289,P<0.05).The average CRT was the same as IVC.The mean CRT was significantly lower than that brfore IVC,and the difference was statistically significant(t=12.314,13.087,16.496,P<0.05),and the average CRT decreased significantly at 3 and 6 months after IVC.The improvement of visual acuity was obvious at 3 and 6 months after injection.The mean FAZ and vascular density at 1 month,3 months,and 6 months after surgery were statistically significant compared with those before injection.Comparative analysis of mean FAZ and mean VD at 1 and 3 months showed statistically significant difference.IVC treatment in DME patients increased the average vascular density of SCP in the macular fovea,improved blood flow,and reduced FAZ area.The mean VD and mean FAZ of DME were not statistically significant at 3 months and 6 months(t =-2.669,P = 0.12).That is,IVC reduced the area of FAZ and increased the fovea of the macula when followed up to about 6 months.The average blood vessel density of the capillaries does not promote blood flow.Conclusion:1.This study showed that Combercept can effectively reduce the infiltration of blood vessel walls,reduce the thickness of the central retina,and improve the visual acuity of DME patients during follow-up of DME with IVC.2.Although IVC can achieve satisfactory results in the treatment of DME,it has no significant role in reducing the area of FAZ and increasing the density of blood vessels.DME treatment has a long way to go. |
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