玻璃体内注射雷珠单抗联合曲安奈德治疗视网膜中央静脉阻塞所致黄斑水肿  

Intravitreal injection of ranibizumab combined with triamcinolone acetonide for macular edema secondary to central retinal vein occlusion in young adults

作　　者：付淑颖 陈悦[1] 

机构地区：[1]郑州大学第一附属医院眼科,450052

出　　处：《中华眼外伤职业眼病杂志》2016年第3期179-183,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的观察玻璃体内注射雷珠单抗（ranibizumab）联合曲安奈德（triamcinoloneace—tonide）治疗中青年视网膜中央静脉阻塞所致黄斑水肿（CRVO-ME）的临床效果及安全性。方法临床回顾性研究，CRVO—ME28例（28只眼）接受玻璃体内注射雷珠单抗0．5mg联合曲安奈德1mg，必要时重复注射。随访6个月。观察治疗前，治疗后2周，1、2、3、4、5及6个月的最佳矫正视力（10g—MAR，BCVA）、黄斑中心区视网膜厚度（CMT）及眼压的变化。结果治疗前BCVA为1．03±0．16，治疗后2周，1、2、3、4、5及6个月时BCVA分别为0．80±0．31、0．46±0．06、0．30±0．23、0．43±0．23、0．37±0．22、0．304-0．04及0．26±0。14，治疗后各时间点BCVA均较治疗前明显提高，差异均有统计学意义（P〈0．05）；治疗前CMT为（459．68±73．13）μm，治疗后各时间点CMT分别为（381．59±70．83）μm、（262．52±33．99）μm、（244．02±72．05）μm、（273．87±53．45）μm、（252．52±41．67）μm、（234．67±23．88）μm及（225．25±11．23）μm，治疗后各时间点黄斑区水肿均减退，差异均有统计学意义（P〈0．05）；治疗后各时间点眼压与治疗前无明显变化，差异无统计学意义（P〉0．05）；随访过程中均未出现白内障或眼内炎等并发症。结论雷珠单抗联合曲安奈德治疗中青年CRVO—ME可以提高视力、减轻黄斑水肿。短期内反复玻璃体内注射后可将视力维持在相对稳定状态，且无重要并发症产生。Objective To observe the clinical effects and safety of intravitreal injection of ranibizumab combined with triamcinolone acetonide for macular edema secondary to central retinal vein occlusion （CRVO-ME） in young adults. Methods This is a clinical retrospective study. Twenty-eight eyes of 28 cases of CRVO-ME were treated with intravitreal injeciton of ranibizumab of 0.5 mg combined with triamcinolone acetonide of 1 mg and the repeat injection was performed when needed. The follow-up time was 6 months. The changes of best corrected visual acuity （ logMAR, BCVA）, central macular thickness （CMT） , and intraocular pressure （IOP） before the treatment and at 2 weeks, 1, 2, 3, 4, 5 and 6 months after the treatment were observed. Results The BCVA before the treatment was 1.03 ＋ 0.16, and were 0.80±0.31, 0.46±0.06, 0.30±0.23, 0.43±0.23, 0.37＋0.22, 0.30±0. IM and 0.26 ^-0. 14, 2 weeks, 1,2, 3,4, 5 and 6 months after the treatment. The BCVA at each time point after the treatment was obviously improved and the differences were statistically significant （ P 〈 0. 05 ）. The CMT before the treatment was （459.68±73.13） μm, and were （381.59 ±70.83）μm, （262.52 ±33.99） μm, （244.02±72.05） tzm, （273.87 ± 53.45 ）μm, （252.52± 41.67）μm, （234.67 ± 23.88）μm and （225.25 ± 11.23 ）μm at each time point after treatment. The CMT at each time point after the treatment was obviously improved and the differences were statistically significant （ P 〈0. 05 ）, The IOP between the time points before the treatment and at each time point after the treatment had no obvious change, and there was no statistically significant difference （ P 〉 0. 05 ）. During the follow-up time no cataract, endophthalmitis or other complication occurred. Conclusion Intravitreal injection of ranibizumab combined with TA for CRVO-ME in young adults can improve visual acuity and reduce macular edema. Repeated intravitreal injection in the short time can maintain the vision in a relatively s

关 键 词：黄斑水肿 视网膜中央静脉阻塞 雷珠单抗 曲安奈德 中青年 

分 类 号：R774.5[医药卫生—眼科]