激光单独或联合Bevacizumab治疗放射性视网膜病变  

Efficacy of photocoagulation alone or combined with intravitreal Bevacizumab for radiation retinopathy

作　　者：赵晓静[1] 杨程成[1] 郑晖[1] 李斌辉[1] 李勤[1] 

机构地区：[1]中山大学附属第五医院眼科,中国广东省珠海市519000

出　　处：《国际眼科杂志》2016年第8期1457-1461,共5页International Eye Science

基　　金：珠海市科技计划项目(No.2013D0401990015)~~

摘　　要：目的:探讨激光单独或联合bevacizumab治疗放射性视网膜病变的疗效。方法:收集2009-01/2014-01于中山大学附属第五医院眼科确诊为放射性视网膜病变并接受激光单独或联合bevacizumab玻璃体腔注射治疗患者进行回顾性分析。共收集43例43眼,其中行激光联合bevacizumab玻璃体腔注射(1.25mg)患者共21例21眼,单独激光治疗患者共22例22眼;对两组患者治疗前及治疗后2wk,1、3、6mo,1a的最佳矫正视力(best-corrected visual acuity,BCVA)、眼压、黄斑中心凹厚度进行观察及对比。结果:(1)BCVA:激光组:治疗后各个时间点与治疗前BCVA对比差异无统计学意义(P>0.05)。联合组:治疗后2wk,1、3、6mo BCVA逐渐提高,在治疗后6mo时BCVA提高最明显,上述各个时间点与治疗前相比,差异均有统计学意义(P<0.05);治疗后1a与治疗前BCVA相比差别无统计学意义(P>0.05)。激光组与联合组对比:治疗后2wk,1、3、6mo两组BCVA比较,联合组在上述各个时间点均优于激光组,差异有统计学意义(P<0.05),在治疗后1a时,两组比较差异无统计学意义(P>0.05);(2)黄斑中心凹厚度(central macular thickness,CMT):激光组:治疗后2wk,1、3、6mo的CMT逐步变薄,在治疗后6mo CMT最薄,上述各个时间点与治疗前相比,差异均有统计学意义(P<0.05);治疗后1a与治疗前相比CMT变薄,差异无统计学意义(P>0.05)。联合组:治疗后2wk,1、3、6mo的CMT逐步变薄,在治疗后6mo CMT最薄,上述各个时间点与治疗前相比,差异均有统计学意义(P<0.05);治疗后1a两组患者CMT比较差异无统计学意义(P>0.05)。激光组与联合组对比:治疗后2wk,1、3、6mo两组CMT比较,联合组各个时间点均较激光组薄,差异有统计学意义(P<0.05);在治疗后1a两组患者CMT比较差异无统计学意义(P>0.05)。结论:在短期(6mo)内激光联合bevacizumab玻璃体腔内注射在促进黄斑水肿消退、提高视力方面较单独激光治疗具有明显优势,但促进黄斑水肿消退�AIM： To evaluate the efficacy of photocoagulation alone or combined with intravitreal Bevacizumab for radiation retinopathy（RR）.METHODS： There were 43 patients（43 eyes）with RR were collected at the Fifth Affiliated Hospital Sun Yet-Sen University between Jan. 2009 and Jan. 2014. Twenty-one patients received the photocoagulation treatment combined with intravitreal bevacizumab and 22 patients received the treatment of photocoagulation alone. All the patients would complete ophthalmologic examinations, including best-corrected visual acuity（BCVA）, intraocular pressure, optical coherence tomography, fundus fluorescein angiography before and after the treatment.RESULTS： BCVA： In monotherapy group, there were no statistically difference about BCVA before and after treatment（P〉0.05）. In combined therapy group, the BCVA had been increasing gradually in 2wk, 1, 3, 6mo after treatment（P〈0.05）. There was no significant difference about BCVA before and 1a after treatment（P〉0.05）. In the comparison of BCVA in these two groups in 2wk, 1, 3, 6mo after treatment, the combined therapy group were better than monotherapy group in each time point（P〈0.05）, but no statistically significant difference was observed in these two groups at 1a after treatment（P〉0.05）. Central macular thickness（CMT）： in monotherapy group, the CMT had been decreasing gradually in 2wk, 1, 3, 6mo after treatment（P〈0.05）. There was no significant difference about CMT before and after 1a treatment（P〉0.05）. In combined therapy group, the CMT had been decreasing gradually in 2wk, 1, 3, 6mo after treatment（P〈0.05）. There was no significant difference about CMT before and 1a after treatment（P〉0.05）. In the comparison of CMT between these two groups in the 2wk, 1, 3, 6mo after treatment, those of combined therapy group were thinner and difference were statistically significant（P〈0.05）, but no statistically significant difference was observed in two groups at 1a after treatment（P�

关 键 词：放射性视网膜病变 抗VEGF 激光 治疗 

分 类 号：R739.63[医药卫生—肿瘤] R779.63[医药卫生—临床医学]