新生血管性青光眼治疗策略的初步探讨  

Initial observation on treatment strategies for neovascular glaucoma

作　　者：梁勇[1] 赵明威[1] 潘中婷[1] 侯宪如[1] 任泽钦[1] 黎晓新[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》2011年第3期231-235,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的建立以完成全视网膜光凝为目标，抗VEGF治疗和抗青光眼手术为核心治疗手段的新生血管性青光眼（neovasculargIaucoma，NVG）的综合治疗方法，探讨NVG的治疗策略。方法设计NVG治疗流程，纳入NVG患者9例10只眼进行综合治疗，治疗方法包括药物降眼压、眼内抗VEGF治疗、单独或联合白内障及玻璃体切割手术的抗青光眼手术以及在此基础上完成全视网膜光凝治疗。随诊6～18（平均9．7）个月，观察患者眼压、视功能及虹膜及房角新生血管状况。结果本组患者治疗前眼压（42．30±10．25）mmHg，治疗后末次随诊眼压（17．30±4．86）mmHg，统计学分析差异具有统计学意义（P〈0．001）。治疗后7只眼视力明显提高。末次随诊时8只眼虹膜及房角新生血管消退。结论以完成全视网膜光凝为目标，抗VEGF治疗和抗青光眼手术为手段的NVG综合治疗方法能有效控制患者眼压并最大限度保护患者的视功能。Objective To establish the efficacy and safety of comprehensive therapy for neovascular glaucoma （NVG） by which the main goal is to complete pan-retinal photocoagulation （PRP） and the core treatment is anti-VEGF injection/anti-glaucoma operation, and to discuss the treatment strategies. Methods To design a medical treatment process for NVG. Ten eyes of 9 patients treated with comprehensive therapy including medications for decreasing intraocular pressure （IOP）, combination cataract remove/vitrectomy/anti-glaucoma operation or anti-glaucoma operation alone and compete PRP after all the basis treatment. To observe IOP, visual function and anterior chamber angle neovascularization for 6-18 months follow-up （average, 9.7 months）. Results The mean IOP was 42.30 mmHg （± 10.25） before treatment, and the mean IOP was 17.30 mmHg （± 4.86） aider treatment. The difference had statistic significance （P 〈0.001）. Visual acuity of 7 eyes was improved significantly after treatment. Iris and anterior chamber angle neovasculization of 8 eyes were regressed completely at the last follow-up. Conclusions IOP is well controlled and v/sual fimction is preserved maximum with comprehensive therapy for NVG by completing PRP and anti-VEGF/anti-glaucoma operation.

关 键 词：新生血管性青光眼 抗VEGF治疗 全视网膜光凝 

分 类 号：R775[医药卫生—眼科]