雷珠单抗治疗视网膜静脉阻塞的临床研究  

Efficacy of intravitreal injection of ranibizumab for retinal vein occlusion

作　　者：周洁[1] 王宏彬[1] 王文亭[1] 

机构地区：[1]首都医科大学附属北京友谊医院眼科,北京市100050

出　　处：《眼科新进展》2016年第1期70-73,共4页Recent Advances in Ophthalmology

摘　　要：目的观察玻璃体内注射雷珠单抗（Ranibizumab）联合视网膜激光光凝治疗合并黄斑水肿的视网膜静脉阻塞（retinal vein occlusion,RVO）的疗效。方法 2013年10月至2015年3月我院确诊为RVO患者32例35眼纳入研究,分为视网膜分支静脉阻塞（branch retinal vein occlusion,BRVO）组18例（19眼）、视网膜中央静脉阻塞（cranch retinal vein occlusion,CRVO）组14例（16眼）。所有患者均接受Ranibizumab玻璃体内注射,采用1＋PRN方案。在初次注射后0.5~1个月,联合视网膜激光光凝治疗。比较两组患者治疗前、治疗后患眼黄斑中心视网膜厚度（macular central retinal thickness,CRT）、国际标准糖尿病早期治疗研究（Early treatment diabetic retinopathy study,ETDRS）视力表、裂隙灯、眼底镜、眼压以及眼底荧光血管造影检查（fluorescein fundus angiography,FFA）。结果随访2~6个月,平均4个月。CRVO组、BRVO组重复注射Ranibizumab的次数分别为（1.83±0.83）次、（1.58±0.67）次。CRVO组、BRVO组治疗前后ETDRS视力比较差异均有统计学意义（t=3.237、6.178,均为P〈0.05）,CRVO组、BRVO组治疗前后CRT差异均有统计学意义（t=3.165、3.598,均为P〈0.05）。两组术后CRT与年龄、糖尿病、高血压因素均无相关性（r=0.114、0.435、0.028、0.269、0.171、0.062,均为P〉0.05）。BRVO组术前CRT及注射次数有相关性（r=0.556,P≤0.05）。结论经玻璃体内注射Ranibizumab联合视网膜激光光凝治疗RVO能促进出血吸收、改善黄斑水肿并且提高视力。两组末次随访CRT与年龄、合并糖尿病、合并高血压因素均无相关性。BRVO组研究结果显示IVR联合视网膜激光治疗疗效优于IVR单项治疗。Objective To observe the effects of intravitreal injection of Ranibizumab combined with laser photocoagulation on macular edema secondary to retinal vein occlusion（RVO）.Methods Thirty-five eyes of 32 patients with macular edema secondary to RVO were included,including 19 eyes（18 cases） of branch retinal vein occlusion（BRVO） and 16eyes（14 cases） of central retinal vein occlusion（CRVO）.The eyes received intravitreal injection of 0.5 mg Ranibizumab（Lucentis） combined with retinal laser photocoagulation within half to one month.The Early treatment diabetic retinopathy study（ETDRS） protocol,central retinal thickness（CRT） and fluorescein fundus angiography（FFA） were observed before and 1week 2 weeks,1 month,2 months,6 months after treatment.Results The follow-up ranged from 2 months to 6 months,averaged 4 months.The injections in CRVO eyes was（1.83 ±0.83） times,and BRVO eyes was（1.58±0.67） times.There were statistical difference in ETDRS vision of CRVO and BRVO eyes between before and after treatment（t = 3.237,6.178,all P〈0.05）.There were statistical difference in CRT of CRVO and BRVO eyes between before and after treatment（t = 3.165,3.598,all P〈0.05）.The postoperative CRT was not related with age,diabetes,hypertension factors（r = 0.114,0.435,0.028,0.269,0.171,0.062,all P〉0.05）.The postoperative CRT of BRVO eyes was related with injection times（r = 0.556,P〈0.05）.Conclusion Intravitreal injection of ranibizumab combined with laser photocoagulation can reduce the degree of CRT,improve the visual function in patients with macular edema resulting from RVO.Several baseline factors including age,diabetes,hypertension factors are not associated with CRT outcomes after treatment.Intravitreal injection of Ranibizumab combined with laser photocoagulation for macular edema secondary to BRVO is effective and superior to intravitreal injection of Ranibizumab only.

关 键 词：视网膜静脉阻塞 黄斑水肿 雷珠单抗 视网膜激光光凝 

分 类 号：R774.1[医药卫生—眼科]