玻璃体腔注射曲氨奈德与Bevacizumab治疗非缺血性视网膜中央静脉阻塞继发黄斑水肿疗效比较  

Intravitreal triamcinolone acetinide vs bevacizumab for macular edema due to non-ischaemic central retinal vein occlusion

作　　者：钱彤[1] 黎晓新[1] 梁建宏[1] 尹虹[1] 齐慧君[1] 

机构地区：[1]北京大学人民医院眼科,视觉损伤与修复教育部重点实验室,北京100044

出　　处：《中国实用眼科杂志》2010年第6期575-578,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的 比较玻璃体腔注射曲氨奈德（triamcinoloneacetonide,TA）与抗血管内皮生长因子单克隆抗体（Bevacizumab）治疗非缺血性视网膜中央静脉阻塞继发黄斑水肿（NI-CME）的临床疗效.方法 采用单中心非随机对照临床回顾性研究,共47例经眼科常规检查以及荧光素眼底血管造影（FFA）和光学相干断层扫描（OCT）检查确诊的NI-CME患者的47只眼纳入观察.患者被分成两组进行玻璃体腔注射TA（4mg/0.1m1）或Bevacizumab（1.25rag/0.05m1）治疗.TA组28例,注射次数1～2次,随诊时间（5.98 4±4.35）月.Bevacizumab组19例,注射次数1-3次,随诊时间（3.20±2.92）月.两组在术前年龄、病程、最佳矫正视力（BCVA）、中心视网膜厚度（CMT）方面均无统计学意义.比较治疗前和治疗后4、8、12周两组间以及各组内部的BCVA、CMT的改变.结果 两组间视力在4周（t=0.141,P=0.889）、8周（1=-1.637,p=0.127）、12周（t=-0.479,P=0.650）时均无统计学意义;CMT在4周（t=0.479,P=0.650）、8周（t=0.743,P=0.478）、12周（t=-1.979,P=0.083）时均无统计学意义.治疗后眼压明显升高仅见于TA组.结论 玻璃体腔注射TA或Bevacizumab治疗非缺血性视网膜中央静脉阻塞继发黄斑水肿,短期内均能明显改善视力,减轻黄斑水肿.此结果还需大样本、多中心的临床随机对照研究.Objective To compare the effect of intravitreal triamcinolone vs intravitreal bevacizumab for the treatment of macular edema in non-ischaemic central retinal vein occlusion.Methods The comparative single-center nonrandomized retrospective clinical interventionalstudy included 47 eyes of 47 patients with non-ischaemic CRVO, macular edema was diagnosed by examination of regular inspection, fundus fluorescein angiography（FFA） and optic coherence tomography（OCT ）.This cases were divided into a a triamcinolone group of 28 patients （4.0 mg triamcinolone） and bevacizumab group of 19 patients （1.25 mg bevacizumab）. During follow-up, 1.1±0.8 re-injections of the triamcinolone group （range： 1-2 injections） and 1.5± 1 re-injections ofbevacizumab （range： 1-3 injections） were administered.The mean follow-up were 5.98±4.35 months in TA group and 3.20±2.92 in bevacizumab group.At baseline, both study groups did not vary significantly in age, duration of symptoms ,visual acuity （BCVA）,center macular thickness （CMT）.Comprehensive ophthalmic evaluation was performed at baseline and at weeks 4,8,12 after treatment.Main outcome measures included CMT measured with OCT and BCVA. Results No significant differences between groups were observed for BCVA at week4（t=-0.141, P=0.889）, 8（t=-1.637, P=0.127）, 12（t=-0.479, P=0.650 ）and for CMT at weeks4 （f=-0.479, P=0.650）, 8 （（=0.743, P=0.478）, 12 （t=1.979, P=0.083）.There was a significant increase in 10P in the TA group. Conclusion The result in our observation showed that intravitreal injection of either triamcinolone acetonide or bevacizumab was well tolerated with a significant improvement in BCVA and decrease in macular edema for patients with non-ischaemic retinal vein occlusion .A randomly controlled multicenter clinical trial is necessary.

关 键 词：曲氨奈德 BEVACIZUMAB 视网膜静脉阻塞 黄斑水肿 

分 类 号：R979.1[医药卫生—药品]