Avastin联合黄斑格栅样光凝治疗糖尿病黄斑水肿观察  

Clinical investigation of intravitreal Avastin and macular grid photocoagulation for diabetic macular edema

作　　者：胡忆群[1] 陈青山[1] 方敏[1] 佘洁婷[1] 杨旭[1] 

机构地区：[1]深圳市眼科医院,深圳518001

出　　处：《中国实用眼科杂志》2012年第6期670-672,共3页Chinese Journal of Practical Ophthalmology

基　　金：深圳市科技计划项目（201103371）

摘　　要：目的观察玻璃体腔注射Avastin联合黄斑格栅样光凝治疗糖尿病黄斑水肿的效果。方法临床病例对照研究。对2010年5月至2011年5月在深圳市眼科医院就诊病人，将符合纳入标准并经眼底荧光造影（fundus fluoresceinan giography，FFA）及相干光断层扫描（optical coherence tomog．raphy，OCT）确诊为糖尿病黄斑水肿（diabetic macular edema，DME）的患者45例59只眼，随机分为A、B二组，A组21例26只眼；B组24例33只眼。A组：单纯光凝组：接受单纯黄斑格栅样光凝；B组：联合治疗组：玻璃体腔注射Avastin1．5mg（0．06m1），一周后给予黄斑格栅样光凝。所有患者治疗前及治疗后1、3、6个月均行视力、眼压、眼底检查和OCT检查。两组治疗前后对比行配对样本t检验统计分析，两组间采用单因素方差分析，P〈0．05认为有统计学意义。结果组内比较：B组治疗后BCVA均优于治疗前，差异均有统计学意义；A组治疗后BCVA稍优于治疗前，差异无统计学意义。两组间治疗后CMT均优于治疗前，差异均有统计学意义。组间比较：治疗前：两组之间BCVA均无统计学意义（F=0．005，P〉O．05）。治疗后：B组优于A组，两组间差异均有统计学意义（F=26．446，P〈0．05）。结论玻璃体腔注射Avastin联合黄斑格栅样光凝治疗糖尿病黄斑水肿疗效显著，可明显提高视力，消除或改善黄斑水肿。但尚需进一步大样本的临床随机对照研究来进一步证实。Objective To investigate the effects of intravitreal Avastin combined with macular grid photocoagulation （MGP） for diabetic macular edema （DME）. Methods Fouty-five DME patients （59 eyes） were divided into two groups randomly, 26 eyes received MGP （MGP Group） and 33 eyes re- ceived intravitreal injection of 1.5 mg Avastin followed by MGP （combined Group）. All eyes under- went a complete ophthalmic examination including BCVA, IOP, and OCT at baseline and 1, 3, 6 months after treatment. The outcome measures were the changes compared with baseline in BCVA, changes in CMT. Dates were analyzed using the paired t-test and one-way ANOVA （SPSS 13.0）. The BCVA levels were converted to logMAR equivalents and analyzed. P 〈 0.05 was considered sta- tistically significant. Results After treatment, the improvement in CMT in the MGP group was signif- icant, yet there was no significant improvement in the mean BCVA （logMAR）. The improvement in mean CMT was significant at 1, 3, 6 month （P 〈 0.01）, with corresponding improvement in the combined group. The BCVA did not deteriorate below baseline in all eyes included in the study, ex- cept two eyes in the MGP group. No complication related to the intravitreal injection occurred. Con- clusions. Combination treatment with intravitreal Avastin and macular grid photocoagulation for DME is well tolerated, with a significantly improvement in BCVA and CMT. This suggests combina-tion treatment with intravitreal Avastin and macular grid photocoagulation for diabetic merits further investigation.

关 键 词：AVASTIN 黄斑格栅样光凝 糖尿病黄斑水肿 

分 类 号：R774.5[医药卫生—眼科]