曲安奈德与雷珠单抗治疗继发性黄斑水肿的比较  

Comparison between triamcinolone acetonide and rannibizumab for the treatment of secondary macular edema

作　　者：杨倩倩[1] 张金嵩[2] 刘德成[1] Yang Qianqian;Zhang Jinsong;Liu Decheng(Department of Ophthalmology,The Seventh People's Hospital of Zhengzhou,Zhengzhou 450016,China;Department of Ophthalmology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州市第七人民医院眼科,450016 [2]郑州大学第一附属医院眼科,郑州450052

出　　处：《中华眼外伤职业眼病杂志》2021年第2期135-140,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的比较后部眼球筋膜下注射曲安奈德与玻璃体内注射雷珠单抗对视网膜中央静脉阻塞继发黄斑水肿的疗效。方法回顾性分析郑州市第七人民医院2016年6月至2019年6月60例(60眼)视网膜中央静脉阻塞继发黄斑水肿的资料。所有患者分为雷珠单抗组和曲安奈德组,每组30例(30眼)。分别进行雷珠单抗玻璃体内注射及曲安奈德后部眼球筋膜下注射,均联合视网膜激光光凝。于注射后1、3和6个月观察疗效。结果注射后1个月,曲安奈德组视力(BCVA)优于雷珠单抗组(t=4.240,P=0.044),治疗后3个月及6个月两组差异无统计学意义(P>0.05)。治疗后1个月,雷珠单抗组黄斑中心区厚度高于曲安奈德组(t=2.116,P=0.022),治疗后3个月及6个月曲安奈德组高于雷珠单抗组(t=3.3862236,P=0.018、0.015)。雷珠单抗组治疗1个月后眼压较治疗前明显升高(P<0.05)。曲安奈德组治疗后各时间点眼压较治疗前均无明显升高(P>0.05)。结论与雷珠单抗相比,后部眼球筋膜下注射曲安奈德疗效更好,无眼压升高的风险,而且注射操作简单而安全。Objective To compare the efficacy between intravitreal injection of ranibizumab and injection of triamcinolone acetonide(TA)under posterior tenon's capsule for the treatment of macular edema secondary to central retinal vein occlusion(CRVO).Methods The clinical data of 60 eyes of 60 patients with secondary macular edem a due to CRVO from Jun.2016 to Jun.2019 in Seventh People's Hospital of Zhengzhou were analyzed retrospectively.These patients were divided into Ranibizumab group and TA group,and 30 eyes of 30 cases in each group.The two groups were treated with intravitreal injection of Ranibizumab and TA injection under posterior tenon*s capsule,respectively.All patients received combined with retinal laser photocoagulation.The efficacy between the two groups were compared at 1 month,3 months and 6 months after injection.Results BCVA in TA group was better than that in Ranibizumab group at 1 month after injection(t=4.240,P=0.044).The difference was not statistically significant in BCVA between the two groups at 3 and 6 months after treatment.At 1 month after treatment the central macular thickness(MT)in Ranibizumab group was higher that than in TA group(t=2.116,P=0.022).At 3 and 6 months after treatment,the CMT in the TA group were higher than those in Ranibizumab group(t=3.386,2.236,P=0.018,0.015).At 1 month after treatment,the intraocular pressure in Ranibizumab group was significantly higher than that before treatment(P<0.05).There was no significant change in TA group at all time points after treatment compared with that before treatment(P>0.05).Conclusion The triamcinolone acetonide injection under tenon's capsule has better efficacy than Rannibizumab,no risk of elevated intraocular pressure and the injection is simple and safe.

关 键 词：阻塞 静脉 视网膜 中央 水肿 黄斑 继发性 注射 眼球筋膜下 后部 曲安奈德 注射 玻璃体内 雷珠单抗 光凝 

分 类 号：R774.5[医药卫生—眼科]