| 摘要: |
| ［摘要］ 目的 分析缺血性视网膜静脉阻塞继发黄斑水肿（RVO-ME）患者基线血清己糖激酶1抗体滴度与抗血管内皮生长因子（VEGF）治疗后视力改善的相关性。方法 招募2017年6月至2020年2月在首都医科大学宣武医院确诊为缺血性RVO-ME并接受初始抗VEGF治疗的53例患者，其中缺血性视网膜中央静脉阻塞（CRVO）23例（CRVO组），缺血性视网膜分支静脉阻塞（BRVO）30例（BRVO组）。另选取该院同期30例行超声乳化的白内障患者作为对照组。研究对象行基线血清己糖激酶1抗体滴度检测、眼科常规检查和光学相干断层成像（OCT）检查。所有RVO-ME患者按照“3+按需治疗方案（pro re nata，PRN）”向玻璃体内注射抗VEGF药物治疗。随访12个月，采用多元线性回归分析缺血性RVO-ME患者抗VEGF治疗后视力改善的影响因素。结果 CRVO组基线logMAR BCVA高于对照组和BRVO组，CRVO组和BRVO组基线CRT、基线血清己糖激酶1抗体滴度高于对照组，且CRVO组基线CRT、基线血清己糖激酶1抗体滴度高于BRVO组，差异有统计学意义（P<0.05）。RVO-ME患者基线血清己糖激酶1抗体滴度与随访6个月（r=0.377，P=0.005）、9个月（r=0.362，P=0.008）和12个月（r=0.465，P<0.001）时BCVA改善呈正相关，与随访12个月时中断EZ横向长度减少值（r=0.401，P=0.001）呈正相关。多元线性回归分析结果显示，基线logMAR BCVA、基线血清己糖激酶1抗体滴度是缺血性RVO-ME患者抗VEGF治疗随访12个月时BCVA改善的影响因素（P<0.05）。 结论 己糖激酶1抗体作为一种新的血清生物标志物，与缺血性RVO-ME患者抗VEGF治疗后的视力改善相关。 |
| 关键词: 视网膜静脉阻塞 黄斑水肿 己糖激酶1抗体 抗血管内皮生长因子药物 视力改善 |
| DOI：10.3969/j.issn.1674-3806.2024.04.08 |
| 分类号: |
| 基金项目:北京市科学技术委员会首都临床特色应用研究与成果推广（编号：Z17110001017029） |
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| Analysis on the correlation between baseline serum hexokinase 1 antibody titer and vision improvement after anti-VEGF treatment in patients with ischemic macular edema secondary to retinal vein occlusion |
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WANG Xizhe, LIU Dachuan, ZHANG Lu, WANG Yenan, LI Zhen, FANG Wei
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Department of Ophthalmology, Xuanwu Hospital Capital Medical University, Beijing 100000, China
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| Abstract: |
| ［Abstract］ Objective To analyze the correlation between baseline serum hexokinase 1 antibody titer and vision improvement after anti-vascular endothelial growth factor(VEGF) treatment in patients with ischemic macular edema secondary to retinal vein occlusion(RVO-ME). Methods A total of 53 patients who were diagnosed with ischemic RVO-ME and received initial anti-VEGF treatment in Xuanwu Hospital Capital Medical University from June 2017 to February 2020 were recruited, including 23 cases of ischemic central retinal vein occlusion(CRVO)(CRVO group) and 30 cases of ischemic branch retinal vein occlusion(BRVO group). In addition, 30 cataract patients who underwent phacoemulsification in Xuanwu Hospital Capital Medical University during the same period were selected as the control group. All the subjects underwent baseline serum hexokinase 1 antibody titer detection, routine ophthalmic examination and optical coherence tomography(OCT) examination. All the ROV-ME patients received intravitreal injection of anti-VEGF drugs for treatment according to the “3+ on-demand treatment protocol(pro re nata, PRN)”. After 12 months of follow-up, the influencing factors of vision improvement in patients with ischemic RVO-ME after anti-VEGF treatment was analyzed by using multiple linear regression. Results The baseline logarithm of the minimum resolution angle unit for best corrected visual acuity(logMAR BCVA) in the CRVO group was higher than that in the control group and the BRVO group, and the baseline central retinal thickness(CRT) and baseline serum hexokinase 1 antibody titer in the CRVO group and the BRVO group were higher than those in the control group, and the baseline CRT and baseline serum hexokinase 1 antibody titer in the CRVO group were higher than those in the BRVO group, and the differences were statistically significant(P<0.05). In the RVO-ME patients, baseline serum hexokinase 1 antibody titer was positively correlated with BCVA improvement 6 months(r=0.377, P=0.005), 9 months(r=0.362, P=0.008) and 12 months(r=0.465, P<0.001) after follow-up, and was positively correlated with the transverse length reduction value of ellipsoid zone(EZ) band interruption 12 months after follow-up(r=0.401, P=0.001). The results of multiple linear regression analysis showed that baseline logMAR BCVA and baseline serum hexokinase 1 antibody titer were influencing factors for BCVA improvement in ischemic RVO-ME patients 12 months after anti-VEGF treatment(P<0.05). Conclusion Hexokinase 1 antibody is a novel serum biomarker associated with vision improvement after anti-VEGF treatment in patients with ischemic RVO-ME. |
| Key words: Retinal vein occlusion Macular edema Hexokinase 1 antibody Anti-vascular endothelial growth factor(VEGF) drug Vision improvement |
