玻璃体内注射阿柏西普治疗顽固性糖尿病黄斑水肿的疗效  

Efficiency of intravitreal aflibercept for the treatment ofrefractory diabetic macular edema

作　　者：肖康 梁申芝[1] 万光明[1] 王莉 XIAO Kang;LIANG Shenzhi;WAN Guangming;WANG Li(Department of Ophthalmology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China;Henan Academy of Medical Science,Zhengzhou 450000,Henan Province,China)

机构地区：[1]郑州大学第一附属医院眼科,河南省郑州市450052 [2]河南省医学科学院,河南省郑州市450000

出　　处：《眼科新进展》2020年第8期744-746,共3页Recent Advances in Ophthalmology

基　　金：国家自然科学基金面上项目(编号81970824);河南省科技创新杰出人才计划(编号184200510005)。

摘　　要：目的研究玻璃体内注射阿柏西普治疗顽固性糖尿病黄斑水肿的短期效果。方法收集2018年6月至2019年6月来我院眼科就诊的顽固性糖尿病黄斑水肿患者30例(30眼),行玻璃体内注射阿柏西普治疗。治疗前所有患者均接受过至少3次的玻璃体内注射雷珠单抗治疗,随访期为1个月。在术前及术后1个月时,检查患者最佳矫正视力(best corrected vision acuity,BCVA)和眼压,并行黄斑区光学相干断层成像检查,记录黄斑中心区厚度(central macular thickness,CMT)。比较治疗前后各组数据差异。结果BCVA从阿柏西普治疗前的(0.61±0.26)logMAR提升至治疗后1个月的(0.51±0.19)logMAR,差异有统计学意义(P=0.016)。治疗前CMT为(441.77±108.09)μm,治疗后1个月CMT为(354.47±83.93)μm,差异有统计学意义(P<0.001)。治疗前及治疗后1个月眼压相比,差异无统计学意义(P>0.05)。在随访期间未发现任何眼部及全身相关并发症。结论对于雷珠单抗不应答的顽固性糖尿病黄斑水肿患者,转为阿柏西普治疗能在短期内减轻黄斑区水肿程度,提高视力且无并发症的发生。Objective To assess the short-term therapeutic effect of switching from Ranibizumab to Aflibercept in the treatment of refractory diabetic macular edema(DME).Methods We retrospectively reviewed patients with refractory DME who were treated from Ranibizumab to Aflibercept between June 2018 and June 2019.All patients had underwent at least three injections of Ranibizumab before the conversion.The best corrected visual acuity(BCVA),central macular thickness(CMT)and adverse events were recorded and compared before the conversion and 1 month after the injection at the follow-up time.Results The BCVA improved from(0.61±0.26)logMAR before the conversion to(0.51±0.19)logMAR after the injection at 1 month,with significant difference(P=0.016).The CMT decreased from(441.77±108.09)μm before the conversion to(354.47±83.93)μm after the injection at 1 month,and the difference was statistically significant(P<0.001).There was no significant difference of intraocular pressure between l month after injection and before injection(P>0.05).In addition,no adverse events were observed during the follow-up.Conclusion For patients with refractory DME,intravitreal injection of Aflibercept may be a safe and effective choice in alleviating macular edema and promoting BCVA.

关 键 词：雷珠单抗 阿柏西普 顽固性糖尿病黄斑水肿 

分 类 号：R774.5[医药卫生—眼科]