MGL联合玻璃体腔注射Ranibizumab治疗CRVO并发黄斑水肿的临床疗效  

Clinical effect of MGL combined with vitreous cavity injection of Ranibizumab in the treatment of CRVO complicated with macular edema

作　　者：马庆祥[1] 赵源 MA Qing-xiang ZHAO Yuan(Department of Ophthalmology, Yulin First Hospital, Yulin 719000, China Prevention and Disease Control Center of Zizhou County, Zizhou 718400, China)

机构地区：[1]榆林市第一医院眼科,陕西榆林719000 [2]子洲县疾病预防控制中心,陕西子洲718400

出　　处：《延安大学学报（医学科学版）》2016年第3期12-16,共5页Journal of Yan'an University:Medical Science Edition

摘　　要：目的探讨黄斑格栅光凝（MGL）联合玻璃体腔注射雷珠单抗（Ranibizumab）治疗视网膜中央静脉阻塞（CRVO）并发黄斑水肿的临床效果和安全性。方法选取榆林市第一医院在2015-01~2015-12期间收治的46例视网膜中央静脉阻塞（CRVO）并发黄斑水肿患者,共46眼,随机分为雷珠单抗组和曲安奈德组,各23例（23眼）,前者给予黄斑格栅光凝联合玻璃体腔注射雷珠单抗治疗,后者给予黄斑格栅光凝联合玻璃体腔注射曲安奈德进行治疗。结果治疗后1周、1月、3月、6月,两组患者的BCVA值较治疗前均显著升高,而CMT值较治疗前均显著降低（P〈0.05或P〈0.01）。治疗后1周、1月、3月、6月,雷珠单抗组患者的眼压值较为稳定（P〉0.05）。治疗后1月,曲安奈德组患者的眼压值显著高于雷珠单抗组（P〈0.05）。结论黄斑格栅光凝（MGL）联合玻璃体腔注射雷珠单抗进行治疗视网膜中央静脉阻塞并发黄斑水肿是一种安全、有效的治疗方案,能够提高患者的最佳矫正视力水平,降低黄斑水肿程度,由于手术操作严格内眼手术规范完成治疗,还可降低眼压升高及全身并发症的发生,值得临床推广应用。Objective To study the clinical effects and safety of macular grid photocoagulation（ MGL） combined with intravitreal injection of Ranibizumab for treatment of macular edema secondary caused by central retinal vein occlusion（ CRVO）. Methods 46 cases（ 46 eyes） of CRVO complicated with macular edema were chose from January 2015 to December 2015 in our hospital,and were randomly divided into Ranibizumab group and triamcinolone acetonide group,each with 23 patients（ 23 eyes）. The patients in the former group were given MGL combined with intravitreal injection of Ranibizumab for treatment,while the patients of the latter group were given MGL combined with intravitreal injection of triamcinolone acetonide for treatment. Results After treatment 1 w,1mo,3 mo,6 mo,BCVA values of patients in two groups were both higher than before treatment,while the CMT values were both lower than before treatment（ P〈0. 05 or P〈0. 01）. After treatment 1 w,1mo,3 mo,6 mo,the intraocular pressure value in patients of triamcinolone acetonide group were increased,among which 1 mo after treatment,the intraocular pressure value was higher than before treatment（ P〈0. 05）; After treatment 1 w,1mo,3 mo,6 mo,the intraocular pressure value of patients in ranibizumab group was relatively stable（ P〈0. 05）. After treatment 1 mo,the intraocular pressure value of patients in triamcinolone acetonide group were higher than ranibizumab group（ P〈0. 05）.Conclusion MGL combined with intravitreal injection of Ranibizumab is a safe and effective method for treatment of macular edema secondary caused by CRVO. It can improve BCVA,CMT values without elevated intraocular pressure and systemic complications by operating strictly followed eye surgery treatment specification,thus is worthy of clinical popularization and application.

关 键 词：黄斑水肿 视网膜中央静脉阻塞 玻璃体腔注射 雷珠单抗 

分 类 号：R774.5[医药卫生—眼科]