抗VEGF注射对视神经头部的立即作用:眼内压力和解剖外皮皮质变化之间的相关性
Pasquale Viggiano1, Rosa Buonamassa1, Maria Oliva Grassi1
1Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Bari, Italy.
European journal of ophthalmology
|October 30, 2023
概括
抗VEGF内注射后,眼内压 (IOP) 急剧增加,导致视网膜神经纤维层 (RNFL) 厚度降低,特别是在鼻子部门. 这种IOP峰值可能会导致新血管与年龄相关的黄斑退行症患者的视神经损伤.
科学领域:
- 眼科医生 眼科 眼科
- 视网膜成像 视网膜成像
- 血管生物学 血管生物学
背景情况:
- 内注射抗VEGF药物是新血管与年龄相关的黄斑退化症 (nAMD) 的标准治疗方法.
- 这些注射后眼内压力 (IOP) 的急性变化尚未完全理解.
- 光学连贯断层扫描 (OCT) 和OCT血管扫描 (OCTA) 是评估视网膜结构和血管系统的关键成像方法.
研究的目的:
- 通过使用OCT和OCTA,研究视网膜神经纤维层 (RNFL) 厚度和辐射周毛细血管 (RPC) 的变化.
- 为了评估与急性增加的IOP相关的变化,在nAMD患者内内注射后立即进行内内注射.
主要方法:
- 观察性临床研究涉及35个眼睛的治疗先的nAMD患者接受aflibercept静脉注射.
- 在注射前 (T0) 和注射后 (T1) 立即测量了周周毛囊OCTA输液密度,RNFL厚度和IOP.
- 配对t测试和皮尔森相关性用于注射前和注射后数据的统计分析.
主要成果:
- 与基线 (平均17.26 mmHg) 相比,注射后立即观察到IOP显著急性增加 (平均34.7 mmHg).
- 注射后注意到全球RNFL厚度的显著减少 (P=0.001),鼻腔和下部部门受到影响最大.
- 在全球RNFL厚度和IOP变化之间发现了显著的负相关性 (r=-0.126,P=0.031),而鼻腔RNFL显示出更强的相关性.
结论:
- 抗VEGF静脉注射后急性IOP峰值与nAMD患者的RNFL厚度降低有关.
- 鼻腔RNFL部门似乎最容易受到IOP波动的影响,这可能解释注射后视力敏度的突然变化.
- 这些发现凸显了由于急性内压升高而导致视神经头部损伤和眼性变化的风险.
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