抗新生血管药物玻璃体腔注射与视网膜激光光凝联合治疗，视网膜血管疾病治疗值得探索的新课题  

A new project worth further investigation： combined treatment of retinal vascular disease with intravitreal injection of antiangiogenic agents and retinal photocoagulation

作　　者：张风[1] 

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心北京市眼科学与视觉科学重点实验室, 100730

出　　处：《中华眼底病杂志》2013年第6期553-555,共3页Chinese Journal of Ocular Fundus Diseases

摘　　要：视网膜血管疾病治疗过程中，抗新生血管生成药物玻璃体腔注射能够使新生血管消退，减轻眼内炎症，降低视网膜血管通透性，治疗黄斑水肿，控制新生血管。但其药物作用时间不持久，需要重复治疗。存在治疗操作风险以及成本费用较高等问题。视网膜激光光凝治疗能够封闭视网膜毛细血管无灌注区和新生血管，减轻血管渗漏所导致的黄斑水肿。但其治疗作用是建立在病变区域视网膜组织破坏基础之上，要经过一段时间病变才能逐步稳定而缓慢显示出治疗效果。当病变稳定时，可能视网膜特别是黄斑区已经产生了结构上不可逆转的损伤。所以，一些患者虽然疾病得以控制，黄斑水肿消退，解剖层面的组织结构改善，但视力提高并不令人满意。正确评估抗新生血管药物玻璃体腔注射与视网膜激光光凝治疗的利弊，采用恰当的方式联合治疗，是视网膜血管疾病治疗值得提倡并努力探索的新课题。Intravitreal injection of antiangiogenic agents is widely used to treat retinal vascular disease. This therapy can induce regression of neovascular vessels; reduce intraocular inflammation and retinal vascular permeability, and control macular edema. However the action period of these agents is short, and thus this therapy need repeated injections which cause higher operation risk and cost. Retinal laser photocoagulation therapy can close retinal capillary non-perfusion area and neovascular vessels, reduce macular edema caused by vascular leakage. However, as its therapeutic effect is based on the destruction of the retinal tissues in the lesion area, this therapy need longer time to show its effects. When the disease is controlled by this method, it may already induce some structural irreversible damages to the retina, especially the macular. This is why the visual acuity is not satisfactory in some patients, even though the disease get controlled, macular edema gets disappeared and anatomical structure of retina get improved. Properly evaluating all the pros and cons of retinal photocoagulation and intravitreal injection of antiangiogenic agents, will allow us to explore a better way to combine these two therapies to treat retinal vascular diseases.

关 键 词：视网膜疾病 治疗 视网膜新生血管化 治疗 抗体 单克隆 治疗应用 激光凝固术 述评 

分 类 号：R774.1[医药卫生—眼科]