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Using OCT Angiography To Observe The Effect Of Intravitreal Injection Of VEGF Inhibitor On Neovascularization In Proliferative Diabetic Retinopathy

Posted on:2020-02-25Degree:MasterType:Thesis
Country:ChinaCandidate:X Q LiFull Text:PDF
GTID:2404330590965161Subject:Ophthalmology
Abstract/Summary:PDF Full Text Request
Objective: OCTA was used to continuously observe the regression of neovascularization in proliferative diabetic retinopathy(PDR)and the occurrence or aggravation of tractional retinal detachment(TRD)after intravitreal injection of VEGF inhibitor,so as to guide the choice of vitrectomy time.Method:Patients who can diagnose by FFA as PDR and observe optic disc neovascularization(NVD)or other neovascularization(NVE)by OCTA were included in the study,and then received intravitreal injection of VEGF inhibitor 0.05ml(0.5mg).OCTA was used for continuous observation for 6 days after injection,the regression of neovascularization and the appearance or aggravation of TRD were observed and recorded emphatically.According to the patient's condition,the fundus laser photocoagulation or vitrectomy was performed and the bleeding during the vitrectomy was observed and recorded.The relationship between the changes of NVD / NVE area and vessel density with time was calculated using ImageJ software.Results: NVD/NVE PDR patients in 13 cases and 19 eyes who can be observed by OCTA were included in the study.Among them,8 cases of NVD were 11 eyes,4 cases of NVE were 6 eyes,and 1 case of NVD combined with NVE was 2 eyes.All patients received 0.05ml(0.5mg)intravitreal conbercept injection.statistically significant regression in the NVD size and vessel density was observed as early as 1day after intravitreal injection of VEGF inhibitor,and the regression changes were significant from 1day to 3days,the regression of both was slightly changed from the third day after injection.The reduction in the NVD/NVE size and vessel density was statistically significant at 1day,2 days,and 3 days after injections compared with the baseline measurements(all P<0.05).The changes were not statistically significant in 4days,5days,and 6days measurements(all P>0.05).TRD was not involved in macular fovea in 9 eyes before injection and was aggravated in 1 eye after injection,but there was no change in the rest.In the process of vitrectomy to remove the observed neovascularization membrane,there was no obvious bleeding in the patients requiring intraocular electrocoagulation.Conclusions:For PDR patients with relatively clear refractive stroma,OCTA can clearly show the distribution and blood flow status of neovascularization in posterior polar fundus.After three days of intravitreal injection of VEGF inhibitors,the detectable changes in the regression of neovascularization were slight,the neovascularization come into a relatively stable period,and the risk of bleeding after vitrectomy was reduced.
Keywords/Search Tags:Proliferative diabetic retinopathy, Vascular endothelial growth factor inhibitors, Optical coherence tomography angiography, pars plana vitrectom
PDF Full Text Request
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