玻璃体腔注射雷珠单抗联合激光治疗视网膜中央静脉阻塞继发黄斑水肿  

Intravitreal ranibizumab combined with grid photocoagulation for macular edema of central retinal vein occlusion

作　　者：吴李鑫 张悦 刘海芸[2] 

机构地区：[1]江苏省南通市通州区人民医院眼科,南通226300 [2]上海交通大学附属第一人民医院眼科,上海200080

出　　处：《中国实用眼科杂志》2015年第9期1004-1007,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的 评价玻璃体腔注射雷珠单抗联合黄斑区格栅样光凝（MLG）治疗视网膜中央静脉阻塞继发黄斑水肿的疗效与安全性.方法 临床病例对照研究.将上海市第一人民医院眼科2013年3月～6月期间诊治的非缺血型视网膜中央静脉阻塞继发黄斑水肿患者30例30只眼,分为联合组（16例）和对照组（14例）.联合组使用玻璃体腔注射雷珠单抗联合MLG治疗,每月注射一次雷珠单抗0.05 ml （0.5 mg）共3次,在第3次注射的2周后进行MLG治疗;对照组使用单纯MLG治疗.比较治疗后1、2、3、6个月两组患眼的最佳矫正视力（BCVA）和黄斑中心凹厚度（CMT）.结果 联合组在治疗后1、2、3、6个月时BCVA （ETDRS）与对照组相比差异有统计学意义（1月：48.7 vs 44.2,P =0.036;2月：49.1 vs 44.6,P=0.032;3月：49.7 vs 45.0,P=0.026;6月：50.1 vs 45.1, P=0.025）.联合组在治疗后1、2、3、6个月时CMT和对照组相比早期差异无统计学意义,后期差异有统计学意义（1月：457.6 μm vs 402.5 μm,P=0.146,2月：352.2 μm vs 385.3 μm,P=0.337;3月：276.1 μm vs 357.1 μm,P=0.030;6月：209.8 μm vs 334.1 μm P=0.001）.联合组曾有一只眼出现一过性高眼压.结论 玻璃体腔注射雷珠单抗联合MLG治疗非缺型血视网膜中央静脉阻塞继发黄斑水肿在治疗后1～6个月疗效恢复优于单纯MLG治疗,并且安全。Objective To evaluate the efficacy and safety of intravitreal ranibizumab （IVR） combined with macular laser grid photocoagulation （MLG） versus MLG only in treating macular edema secondary to non-ischemic central retinal vein occlusion （CRVO）.Methods Thirty patients （30 eyes） suffered from non-ischemic macular edema secondary to CRVO were enrolled from Department of Ophthalmology of Shanghai First People＆#39;s Hospital of Shanghai Jiaotong University.These patients were divided into two groups, group A （16 eyes）： combined intravitreal Lucentis and MLGtreatment;Group B （14 eyes）： MLG only.In group A, patients received monthly intravitreal injec-tion of 0.05 ml/（0.5mg） Lucentis for 3 months, and had MLG two weeks after the third intravitreal injection.In group B, patients only received MLG.Then the best-corrected visual acuity （BCVA） and central macular thickness （CMT） were compared between two groups at 1, 2, 3 and 6 month during follow-up.Results BCVA improved more significantly in group A than in group B at 1, 2, 3, 6 month （1 month： 48.7 vs 44.2, P =0.036;2 months： 49.1 vs 44.6, P =0.032;3 months： 49.7vs 45.0, P =0.026;6 months： 50.1 vs 45.1, P =0.025）.CMT were not statistically significant between the two groups at 1, 2 month, and on the contrary at 3 and 6 months （1 month： 457.6 μm vs 402.5 μm, P =0.146, 2 months： 352.2μm vs 385.3μm, P =0.337;3 months： 276.1μ, m vs 357.1μm, P =0.030;6 months： 209.8μm vs 334.1μm, P =0.001）.No serious adverse event was found in both groups, except 1 eye of group A occurred high intraocular pressure for 2 days.Conclusions The efficacy of intravitreal ranibizumab combined with MLG treatment is significantly better than the simple MLG for macular edema secondary to central retinal vein occlusion, and the safety is the same.

关 键 词：非缺血型视网膜中央静脉阻塞 黄斑水肿 激光光凝 雷珠单 

分 类 号：R779.6[医药卫生—眼科]