Guoji Yanke Zazhi (Aug 2021)
Short-term effects of anti-VEGF drugs on macular perfusion in patients with diabetic macular edema
Abstract
AIM: To evaluate the effect of Conbercept or Aflibercept on macular perfusion status in patients with diabetic macular edema(DME), and the changes in foveal avascular zone(FAZ)areas and capillary density in macular regions were measured quantitatively by optical coherence tomography angiography(OCTA).METHODS: Twenty-six patients with DME received intravitreal injections of Conbercept or Alfibercept. The changes of FAZ areas, PERIM, AI, and macular vessel density in fovea of 300μm width(FD-300)were measured by OCTA in baseline 1, 7, and 30d after injection, and the effect of anti-VEGF drugs on blood circulation in macular area was analyzed. The best-corrected visual acuity(BCVA), central foveal thickness(CFT)were observed, the BCVA was converted to LogMAR. The changes of BCVA, CFT, FAZ, FD-300, PERIM, AI treated with anti-VEGF by methods repetitive measure analysis of variance on 1, 7, 30d after treatment were compared. Bonferroni was used to analyze the differences at different time points in pairwise comparison. Pearson correlation analysis was used to evaluate the correlation between changes in BCVA(LogMAR)and FAZ, CFT.RESULTS: The FAZ area was 0.296±0.022mm2 in baseline. After 1d drug injection, the FAZ increased to 0.339±0.024mm2 (P=0.015). There was no significant difference in FAZ on the 7 and 30d after surgery(P=0.084, P=0.224). Compared with before treatment, BCVA and CFT decreased significantly, the anti-VEGF therapy was effective. The changes in PERIM, AI, and FD-300 did not reach significant level(F=2.598, P=0.059; F=0.438, P=0.726; F=0.594, P=0.621). The results of correlation analysis showed that BCVA(LogMAR)was positively correlated with FAZ and CFT(r=0.273, P=0.005; r=0.200, P=0.042)which had influence on BCVA.CONCLUSION: With an increase in the avascular area of macular fovea was detected within 1d after intravitreal injection of anti-VEGF drug in patients with DME, and decrease in the area of avascular area in macular fovea after 1wk, accompanied by improved visual acuity. The selected appropriate index of OCTA can provide a reliable means to measure retinal circulation.
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