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玻璃体内地塞米松植入物对RVO继发性ME视网膜血氧饱和度,血管直径和球后血流速度的影响

Eibenberger, K., Schmetterer, L., Rezar-Dreindl, S., et al.

期刊名称:Investigative Ophthalmology & Visual Science

卷期:2017年第58卷第12期

摘要

摘要:目的:旨在探讨玻璃体腔内0.7mg地塞米松(Ozurdex)植入对视网膜静脉阻塞(RVO)引起的黄斑水肿(ME)患者动脉和静脉氧饱和度,视网膜血管直径和球后血流速度的影响。方法:这项前瞻性,非随机临床试验包括40例由RVO引起的ME患者的40只眼。使用动态血管分析仪测量动脉和静脉血氧饱和度和视网膜血管直径。主要观察指标是视网膜动静脉氧分压差,根据动脉和静脉氧合差值来计算。采用彩色多普勒超声检查测量眼动脉(OA),视网膜中央动脉(CRA)和睫状后动脉(PCA)的收缩期峰值流速(PSV),舒张末期流速(EDV)和阻力指数(RI)。在最初的地塞米松植入物注射后,每月随访一次,随访6个月。采用混合模型研究治疗效果,作为统计学分析。结果:动静脉氧含量差异显着(P <0.01)。动脉血氧饱和度和血管直径对治疗无效(P> 0.05),静脉血氧饱和度和直径与基线相比明显下降(P <0.01)。球后血流速度PSVEDVRIOACRAPCA方面无明显变化(P> 0.05)。结论:RVO患者玻璃体腔内注射地塞米松可增加动静脉血氧饱和度,提示可改善视网膜氧合。治疗后动脉氧合和血管直径没有反应,而静脉氧合和血管直径下降。

Purpose:To investigate the effects of intravitreal 0.7 mg dexamethasone implants (Ozurdex) on arterial and venous oxygen saturation, retinal vessel diameter, and retrobulbar blood flow velocity in patients with macular edema (ME) due to retinal vein occlusion (RVO).Methods:This prospective, nonrandomized clinical trial included 40 eyes of 40 patients with ME due to RVO. Measurements of arterial and venous oxygen saturation and retinal vessel diameters were performed using the Dynamic Vessel Analyzer. The main outcome measure was the retinal arteriovenous oxygen difference, calculated as the difference between arterial and venous oxygenation. Color Doppler imaging was performed for measuring peak systolic velocity (PSV), end diastolic velocity (EDV), and resistive index (RI) in ophthalmic artery (OA), central retinal artery (CRA), and posterior ciliary arteries (PCAs). Follow-up was monthly for 6 months following an initial dexamethasone implant injection. As statistical analysis, a mixed model was performed to investigate the effect treatment.Results:The arteriovenous oxygen difference showed a significant increase (P < 0.01). Arterial oxygenation and vessel diameter did not respond to the treatment (P > 0.05), while the venous oxygen saturation and diameter decreased significantly (P < 0.01) compared to baseline. The retrobulbar blood flow velocities PSV, EDV, and RI showed no change in the OA, CRA, and PCA (P > 0.05).Conclusions:In patients with RVO, intravitreal dexamethasone treatment leads to an increase in arteriovenous oxygen saturation difference indicating improved retinal oxygenation. Arterial oxygenation and vessel diameter showed no response, whereas venous oxygenation and vessel diameter decreased after treatment.


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