mfERG分析雷珠单抗眼内注射对RVO合并黄斑水肿的疗效  

Efficiency analysis by mfERG of intraocular injection with ranibizumab on retinal vein occlusion combined with macular edema

作　　者：阎静[1] 徐冲[1] 吴建华[1] 

机构地区：[1]武汉爱尔眼科医院,中国湖北省武汉市430060

出　　处：《国际眼科杂志》2015年第3期486-488,共3页International Eye Science

摘　　要：目的：利用多焦视网膜电流图（multifocal ERG,mfERG）对雷珠单抗（ranibizumab）治疗视网膜静脉阻塞合并黄斑水肿的患者黄斑区视网膜功能变化进行检测,分析雷珠单抗治疗黄斑水肿后视网膜功能的变化,评价雷珠单抗治疗黄斑水肿的效果。方法：采用回顾性,自身对照研究方法,将临床确诊为视网膜静脉阻塞合并黄斑水肿的15例患者15眼纳入研究。所有患者均常规行矫正视力,裂隙灯显微镜,眼压,彩色眼底照相,FFA及OCT,中心10°视野,mfERG检查,矫正视力检查采用ETDRS视力表进行。所有患者玻璃腔注射雷珠单抗注射液0.05mL/0.5mg,治疗后随访3~12mo,每月复查一次。观察最佳矫正视力,眼压,眼底,中央黄斑厚度,中心10°视野,mfERG的变化。根据复诊情况,确定有无重复注射治疗的需要。以末次随访为疗效判定时间点,记录并分析治疗前及治疗后患者视野和mfERG的变化。结果：末次随访时,治疗前后中心视野平均缺损显著减少（t=4.01,P〈0.01）,1环和2环N1波潜伏期、P1波潜伏期较治疗前显著降低（t=13.65,16.31,P〈0.01）,1环P1波反应密度值与治疗前相比提高,差异有统计学意义（t=7.78,P〈0.01）。结论：玻璃体腔注射雷珠单抗治疗静脉阻塞继发黄斑水肿预后较好,有利于改善患者黄斑区视网膜的敏感度。mfERG方法能准确客观的反应黄斑水肿患者视网膜功能变化,具有较高的临床应用价值。AIM： To measure the retinal function in retinal vein occlusion（ RVO） combined with macular edemain patients treated with ranibizumab by using multifocal ERG（ mfERG）,and to analyze and evaluate the effects of ranibizumab treatment on macular edema.METHODS： A retrospective,self- control method was used. Fifteen eyes of 15 patients who were clinically diagnosed as RVO with macular edema were included in this study. All patients were routinely corrected visual acuity,slit lamp microscopes,intraocular pressure,color fundus photography,FFA and OCT,the central 10° vision field,mfERG examination,corrected visual acuity using ETDRS visual acuity table. All patients were treated with intravitreal injection of ranibizumab 0. 05mL/0. 5mg and follow- up 3 ~ 12 mo,including the monthly review once.The best corrected visual acuity, intraocular pressure,fundus,central macular thickness,central 10° vision field,the change of mfERG of these patients were observed.According to the referral,the repeated injection treatment was decided. The end of the follow- up was the time point to determine the efficacy,and the changes of vision field and mfERG in patients were recorded and analyzed.RESULTS： The central visual field mean defect（ MD）was significantly decreased at last follow- up（ t = 4. 01,P〈0. 01）. The 1st and 2nd ring N1 wave latency and the former P1 wave latency were significantly reduced（ t =13.65,16. 31,P〈0. 01）. The density values of P1 wave from treatment response in 1st ring were significantly increased（ t =7. 78,P〈0. 01）. CONCLUSION： Intravitreal injection of ranibizumab treatment of macular edema secondary to venous occlusion can give a better prognosis and improve the sensitivity of patients＇ macular. The method of mfERG can accurately and objectively reflect the retinal function changes in patients with macular edema and could be potentially used in clinical.

关 键 词：多焦视网膜电图 雷珠单抗 视网膜静脉阻塞 黄斑水肿 

分 类 号：R774[医药卫生—眼科]