视网膜光凝术联合雷珠单抗治疗新生血管青光眼的临床研究  

Clinical research of retinal laser photocoagulation and Ranibizumab on the treatment of neovascular glaucoma

作　　者：蒋伟鹏 卢珊珊[1] 金益[1] 

机构地区：[1]中国浙江省台州市第一人民医院眼科,318020

出　　处：《国际眼科杂志》2015年第10期1763-1765,共3页International Eye Science

摘　　要：目的：探讨视网膜激光光凝术联合雷珠单抗（ ranibizumab）治疗新生血管青光眼（ neovascular glaucoma, NVG）对视功能的改善及不良反应,为临床治疗提供依据。 方法：选择本院2012-01/2014-06 NVG 患者100例129眼,随机分为观察组和对照组,对照组50例67眼,应用视网膜激光光凝术治疗；观察组50例62眼,应用视网膜激光光凝术联合雷珠单抗进行治疗。评估治疗后虹膜新生血管消退情况、视力恢复、眼压及眼底状况,评估患者不良反应。并应用光学相干断层扫描（ OCT）检测视网膜神经纤维层（ retinal nerve fiber layer, RNFL ）厚度及视野缺损值。 结果：观察组患者虹膜新生血管消失率为95.2%（59/62）,高于对照组83.6%（56/67）；观察组视力4.3~4.7为62.9%（39/62）,高于对照组49.3%（33/67）,观察组视力≤4.3为25.8%（16/62）,低于对照组43.3%（29/67）（P〈0.05）；观察组治疗后视网膜静脉循环时间和眼压分别为8.20±0.41s 和18.50±0.48mmHg,低于对照组9.42±0.30s和23.94±0.52mmHg（P〈0.05）；观察组虹膜新生血管消退时间6.19±0.27d,低于对照组8.37±0.31d （ P〈0.05）；观察组治疗后RNFL厚度为91.12±2.05μm,高于对照组治疗后85.06±2.19μm,观察组治疗后视野缺损值为13.44±0.59dB,低于对照组治疗后15.92±0.56dB（ P〈0.05）。两组患者不良反应结果比较,差异无统计学意义（P〉0.05）。 结论：视网膜激光光凝术联合雷珠单抗治疗NVG具有较好的临床疗效,能够显著改善患者视力及视网膜结构和功能,具有较高的安全性。AIM：To explore the improvement of visual function and the adverse reactions of retinal laser photocoagulation combined with ranibizumab for the treatment of neovascular glaucoma （ NVG ） , to provide the basis for clinical treatment. METHODS： One hundred patients with 129 eyes in our hospital from January 2012 to June 2014 were selected. They were randomly divided into the observation group and the control group, 50 cases in each one. Patients in the control group （67 eyes） were treated with retinal laser photocoagulation, and those in the observation group （62 eyes） were given retinal laser photocoagulation combined with ranibizumab treatment. After the treatment, the degeneration of iris neovascularization, visual acuity, intraocular pressure, ocular fundus and the adverse reactions were evaluated. Optical coherence tomography （ OCT） was used to detect retinal nerve fiber layer （ RNFL） thickness and visual field defect. RESULTS： The degeneration rate of the iris neovascularization in the observation group was 95. 2%（59/62）, higher than that of the control group 83. 6% （56/67） （P〈0. 05）. The visual acuity of the observation group 4. 3 ~ 4. 7 was 62. 9% （39/62）, higher than that of the control group 49. 3% （ 33/67 ）; the visual acuity of the observation group ≤4. 3 was 25. 8% （16/62）, lower than that of the control group 43. 3% （29/67） （P〈0. 05）. The retinal vein circulation time and intraocular pressure of the observation group after treatments were respectively 8. 20±0. 41s and 18. 50±0. 48mmHg, lower than those of thecontrol group 9. 42±0. 30s and 23. 94±0. 52mmHg （ P〈0.05 ） . The degeneration time of the iris neovascularization of the observation group was 6. 19±0.27d, which was lower than that of the control group 8.37±0. 31d （P〈0. 05）. RNFL thickness of the observation group after treatments was 91. 12±2. 05μm, higher than that of the control group 85. 06±2. 19μm; the vision field defect of the observation group after treat

关 键 词：视网膜激光光凝术 雷珠单抗 新生血管青光眼 光学相干断层扫描 

分 类 号：R779.6[医药卫生—眼科]