视网膜分支静脉阻塞致黄斑水肿玻璃体腔注射Avastin疗效分析  

Macular edema patterns and response to intravitreal Avastin therapy in branch retinal vein occlusion

作　　者：李树杰[1] 钱芳[2] 陈晓勇[2] 马志中[2] 郭彤[2] 刘瑜玲[2] 赵琳[2] 

机构地区：[1]滕州市中心人民医院眼科,山东277500 [2]北京大学第三医院眼科,北京大学眼科中心视觉损伤与修复教育部重点实验室,100083

出　　处：《中国实用眼科杂志》2014年第11期1328-1332,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的 评估视网膜分支静脉阻塞（branch retinal vein occlusion,BRVO）继发黄斑水肿时浆液性视网膜神经上皮脱离（serous retinal detachment,SRD）与玻璃体腔注射Avastin疗效之间的关系.方法 临床病例系列研究.回顾性分析2012年6月至2013年9月在北京大学眼科中心行玻璃体腔注射1.25mg （0.05ml） Avastin治疗BRVO继发黄斑水肿患者59例（59只眼）.治疗前及治疗后1、3个月进行最佳矫正视力（BCVA）、眼压、裂隙灯、间接检眼镜检查和彩色眼底照相、光学相干断层扫描（OCT）检查;治疗前及治疗后3月行荧光素眼底血管造影（FFA）检查.根据OCT图像有无SRD,将患者分为SRD（＋）组与SRD（-）组.结果 SRD（＋）组22例（37.29％,22/59）患者,平均年龄低于SRD（-）组差异有统计学意义（P＜0.05）,术前黄斑中心区厚度（central subfield macularthickness,CSMT）明显＞SRD（-）组差异有统计学意义（P＜0.01）.玻璃体腔注射Avastin后1、3个月,SRD（＋）组CSMT的改善幅度明显＞SRD（-）组差异有统计学意义（P＜0.01）;玻璃体腔注射Avastin后3个月,SRD（＋）组BCVA的提高幅度亦大于SRD（-）组差异有统计学意义（P＜0.05）.结论 玻璃体腔注射Avastin治疗BRVO继发黄斑水肿合并SRD的患者CSMT及BCVA改善幅度更大,效果明显.Objective To evaluate the relationship of serous retinal detachment （SRD） and treatment outcome after intravitreal Avastin injection in patients with macular edema due to branch retinal vein occlusion （BRVO）.Methods A retrospective case-observation study.The clinical data of 59 patients （59 eyes） from with macular edema secondary to BRVO who received intravitreal Avastin injection （1.25mg/0.05mL） were included in this study.All the patients did not receive other any therapy prior to the injection of Avastin.Clinical indexes included best corrected visual acuity （BC-VA）,intraocular pressure,slit-lamp examination,stereoscopic biomicroscopy examination and fundus photography,optical coherence tomography （OCT） before injection and 1 month,3 months after initial injection.Fluorescein fundus angiography （FFA） was performed prior to injection and 3 months after initial injection.Patients were separated into 2 groups：SRD （＋） and SRD （-）,according to the presence or absence of SRD on OCT.Results SRD was found in 22 patients （37.29％）.The age was younger in the SRD （＋） group than in the SRD （-） group （P ＜0.05）.The baseline central subfield macular thickness （CSMT） was significantly thicker in the SRD （＋） group than in the SRD （-） group （P ＜0.001）.One month and 3 months after initial intravitreal injection of Avastin,greater reductions in CSMT change from baseline were observed in the SRD （＋） group than in the SRD （-） group （P ＜0.001）.Three months after the initial injection,a grater improvement of BCVA was also found in the SRD （＋） group than in the SRD （-） group （P ＜0.05）.Conclusions Patients with SRD has greater reductions in CSMT and improvements of BCVA after intravitreal Avastin injection in patients with macular edema due to BRVO.

关 键 词：AVASTIN 视网膜分支静脉阻塞 黄斑水肿 浆液性视网膜神经上皮脱离 

分 类 号：R774.1[医药卫生—眼科]