玻璃体内注射雷珠单抗后视网膜分支静脉阻塞性黄斑水肿复发的危险因素分析  

Risk factors for recurrence of macular edema associated with branch retinal vein occlusions after intravitreal injection of Ranibizumab treatment

作　　者：尹小芳[1] 叶祖科[1] 汤秀容[1] 梁影影 黎彦豪 罗书科[1] 卢彦[1] YIN Xiaofang;YE Zuke;TANG Xiurong;LIANG Yingying;LI Yanhao;LUO Shuke;LU Yan(Institute of Ophthalmology,the Second People’s Hospital of Foshan,Foshan 528000,Guangdong Province,China)

机构地区：[1]佛山市第二人民医院眼科研究所

出　　处：《眼科新进展》2020年第1期46-49,共4页Recent Advances in Ophthalmology

基　　金：佛山市医学科研项目(编号:20190116);广东省中医药局科研立项课题(编号:20162134);佛山市科技计划项目(编号:2016AB001731);佛山市国家卫计委级医学重点专科培育项目(编号:Fspy1-2015005)

摘　　要：目的探讨玻璃体内注射雷珠单抗后视网膜分支静脉阻塞(branch retinal vein occlusion,BRVO)性黄斑水肿复发的危险因素。方法回顾性分析2013年1月至2018年1月在我院行玻璃体内注射雷珠单抗治疗BRVO性黄斑水肿患者的临床资料,记录患者的性别、年龄、眼别及术前的最佳矫正视力、眼压、病程、阻塞支分布情况、有无高血压病史、术前脉压差、术前黄斑中心凹厚度(central macular thickness,CMT)、有无联合视网膜激光光凝治疗,根据注射雷珠单抗的次数将患者分为单次注射组和复发组,比较两组之间术前基线资料的差异,运用Logistic回归分析探讨黄斑水肿复发的相关危险因素。结果114例(114眼)纳入研究,其中单次注射组79例,复发组35例,两组相比,复发组的年龄、基线CMT均显著大于单次注射组(均为P<0.05),其余指标两组间相比差异均无统计学意义(均为P>0.05)。Logistic回归分析结果显示,年龄、基线CMT是玻璃体内注射雷珠单抗后BRVO性黄斑水肿复发的危险因素(年龄:OR=1.080,P=0.01;CMT:OR=1.005,P<0.01)。结论年龄和基线CMT是黄斑水肿复发的主要危险因素,年龄越大、基线CMT越高的患者需重复注射雷珠单抗的风险越高。Objective To investigate the risk factors for recurrence of macular edema associated with branch retinal vein occlusions(BRVO)after intravitreal injection of Ranibizumab.Methods The study collected the clinical cases diagnosed with macular edema associated with BRVO and treated with intravitreal injection of Ranibizumab in our department from January 2013 to January 2018.Relevant data were retrospective analyzed,such as gender,age,eye side,preoperative best corrected visual acuity(BCVA),intraocular pressure(IOP),duration,occlusion branch,hypertension history,preoperative blood pressure,preoperative central macular thickness(CMT)and laser treatment history(combined therapy of retinal laser photocoagulation or not).All patients were divided into single injection group and recurrence group based on the injection frequency.The differences of baseline information were compared between the two groups.Logistic regression analysis was performed to investigate the risk factors for recurrence of macular edema.Results There were 114 patients(114 eyes)in this study,including 79 patients in single injection group and 35 patients in recurrence group.Age and baseline CMT in recurrence group were obviously higher than those in single injection group,and statistical differences were observed(all P<0.05).Logistic regression analysis showed that age and CMT were risk factors for the recurrence of macular edema associated with BRVO after intravitreal injection of Ranibizumab(OR=1.08,P=0.01 for age;OR=1.005,P<0.01 for CMT).Conclusion Age and baseline CMT are risk factors for the recurrence of macular edema,the older the patient is and the higher the baseline CMT,the more risk for repeat intravitreal injection of Ranibizumab.

关 键 词：雷珠单抗 视网膜分支静脉阻塞 黄斑水肿 

分 类 号：R774[医药卫生—眼科]