玻璃体内注射Lucentis治疗中心性渗出性脉络膜视网膜病变的临床疗效  

Intravitreal injection of Lucentis for central exudative chorioretinopathy

作　　者：张聪[1] 刘东宁[1] 徐丽[1] 

机构地区：[1]沈阳市第四人民医院眼科,辽宁省沈阳市110031

出　　处：《眼科新进展》2014年第9期864-867,共4页Recent Advances in Ophthalmology

摘　　要：目的评价玻璃体内注射Lucentis治疗中心性渗出性脉络膜视网膜病变(central exudative chorioretinopathy,CEC)的临床疗效。方法 CEC所致黄斑部脉络膜新生血管(choroidal neovascularization,CNV)患眼32例,对比分析单次玻璃体内注射Lucentis治疗前后最佳矫正视力(best corrected visual acuity,BCVA)、光学相干断层扫描(optical coherence tomography,OCT)及荧光素钠血管造影(fundus fluorescein angiography,FFA)的变化。结果玻璃体内注射Lucentis治疗前与治疗后1周、1个月和3个月BCVA分别为0.72±0.07、0.68±0.16、0.39±0.10、0.15±0.08;黄斑中心厚度(fovea centralis thickness,CMT)分别为(439.20±101.16)μm、(321.10±98.20)μm、(257.35±69.85)μm、(267.52±65.37)μm。玻璃体内注射Lucentis治疗后1周、1个月和3个月,BCVA显著提高,CMT显著降低,与治疗前相比差异均有显著统计学意义(均为P>0.01);治疗后1个月、3个月分别与治疗后1周相比,BCVA显著提高,CMT显著降低,差异均有显著统计学意义(均为P<0.01);治疗后1个月和3个月间相比,BCVA、CMT变化差异均无统计学意义(均为P>0.05)。FFA检查显示:治疗后1周:CNV病灶渗漏停止或渗漏减少者21眼(65.63%),持续渗漏11眼(34.38%);治疗后1个月:CNV病灶渗漏停止或渗漏减少者28眼(87.50%),持续渗漏4眼(12.50%);治疗后3个月:CNV病灶渗漏停止或渗漏减少者27眼(84.38%),持续渗漏5眼(15.63%),1眼(3.13%)出现渗漏复发。结论玻璃体内注射Lucentis治疗可以在短期内部分或完全封闭CEC所致的CNV,减轻黄斑水肿、提高BCVA,为CEC的临床治疗提供了新的思路,但其长期效果有待进一步观察。Objective To investigate the efficacy of intravitreal injection of Lucentis for central exudative chorioretinopathy （CEC）. Methods Thirty-two patients （32 eyes） with macniar choroidal neovascularization （CNV） secondary to CEC were chosen,the best corrected visual acuity（ BCVA）, optical coherence tomography （OCT） and fundus fluorescein angiography （FFA） were detected before and after injection. Results The BCVA before injection and l week, 1 month, 3 months after injection were 0.72±0.07,0.68 ± 0. 16,0.39 ± 0. 10,0. 15 ±0.08, respectively, central macular thickness were （439.20 ± 101.16）μm, （ 321. 10 ±98.20 ） μm, （ 257.35 ±59.85 ） μm and （267.52 ± 65.37 ） p.m, respectively,there were significant differences between before and after injection（ all P 〈 0.01 ）, significant differences between 1 month, 3 months and 1 week after injection （ all P 〈 0.01 ）, but no statistical difference between 1 month and 3 months after injection （ all P 〉 0.05 ）. FFA showed no leakage or reduced leakage in 21 eyes （65.63%）,remained leakage in 11 eyes （34.38%） at 1 week after injection;No leakage or reduced leakage in 28 eyes（87.50% ） ,remained leakage in 4 eyes （ 12.50% ） at 1 month after injection; No leakage or reduced leakage in 27 eyes （84. 38% ）, re-mained leakage in 5 eyes（ 15.63% ） at 3 months after injection, 1 eye （3.13%） relapsed leakage. Conclusion Intravitreal injection of Lucentis can increase the visual acuity and decrease the central macuiar thickness significantly in treatment of CNV caused by CEC. It provides a new idea for clinical treatment for CEC, but its long-term efficacy need to be further observed.

关 键 词：脉络膜新生血管 中心性渗出性脉络膜视网膜病变 玻璃体内注射 雷珠单抗 

分 类 号：R774.1[医药卫生—眼科]