Bevacizumab玻璃体内注射联合视网膜光凝及冷凝治疗新生血管性青光眼  

Intravitreal Bevacizumab injection combined with retinal photocoagulation or coagulation for neovascular glaucoma

作　　者：王俊[1] 孟晓光[2] 李秀云[1] 李娜[1] 李聪伶[1] 

机构地区：[1]潍坊医学院附属医院眼科,山东省潍坊市261031 [2]潍坊医学院附属医院关节外科,山东省潍坊市261031

出　　处：《眼科新进展》2014年第6期557-559,共3页Recent Advances in Ophthalmology

摘　　要：目的观察Bevacizumab玻璃体内注射联合视网膜光凝或前部视网膜冷凝治疗新生血管性青光眼的临床疗效。方法31例(31眼)新生血管性青光眼患者接受治疗。31眼玻璃体内注射0.05 mL Bevacizumab后行视网膜光凝,6眼因屈光间质混浊予以后极部视网膜光凝术后行巩膜外冷凝,术后随访6个月,观察眼压、视力及虹膜新生血管变化。结果虹膜表面新生血管22例术后3 d完全消退,9例明显变细;术后7 d后完全消退。术后1周、1个月、3个月、6个月平均眼压分别为23.68 mmHg(1 kPa=7.5 mmHg)、22.35 mmHg、18.27 mmHg、16.53 mmHg。术后1个月,23例视力提高,8例视力无变化,术前术后最佳矫正视力比较,差异均有统计学意义(均为P<0.05)。23例眼压稳定,5例应用噻吗心胺、派立明滴眼后眼压维持在正常范围,3例眼压未控制,其中1例因无光感行睫状体冷冻术,2例行青光眼阀植入后眼压稳定。结论 Bevacizumab玻璃体内注射联合视网膜光凝及冷凝治疗新生血管性青光眼能改善视网膜缺血状态,有效降低眼压,并发症少,为目前治疗新生血管性青光眼安全、有效的治疗方法。Objective To evaluate the efficacy of intravitreal Bevacizumab injection combined with retinal photocoagulation or anterior retinal coagulation for neovascular glaucoma（NVG）. Methods A total of 31 patients（31 eyes） with NVG received treatment. All patients underwent intravitreal Bevacizumab injection（0.05 mL,1.25 mg） combined with retinal photocoagulation, Additional peripheral retinal coagulation were performed in 6 patients with opaque refractive media. The follow-up period was 5 months ,the changes of intraocular pressure（IOP） ,best corrected visual acuity（ BCVA）, iris neovascularization were observed and analyzed before and after the treatment. Resuits Iris neovascularization was disappeared in 22 cases at 3 days after injection, ob- vious slender in 9 cases and disappeared at 7 days after injection. At postoperative 1 week,1 month,3 months,6 months,the average IOP were 23.68 mmHg（ 1 kPa = 7.5 mmHg）, 22. 35 mmHg, 18. 27 mmHg, 16. 53 mmHg, respectively. At postoperative 1 month, BCVA was improved obviously in 23 eyes, stabled in 8 eyes, there was statistical difference（P 〈0.05）. The IOP was controlled in 23 cases,5 cases was controlled in normal added with timolol and brinzolamide, and 3 cases failed to control, in which 1 case received cyclocrytherapy, and the other 2 cases underwent glaucoma valve implantation. Conelusion Intravitreal Bevacizumab injection combined with retinal photocoagulation or retinal coagulation for NVG can improve retinal ischemia and decrease IOP effectively with less complications,itS safely and effective for NVG.

关 键 词：BEVACIZUMAB 新生血管性青光眼 视网膜光凝 前部视网膜冷凝 

分 类 号：R979.1[医药卫生—药品]