玻璃体腔注药术后早期眼压测量必要性的临床研究  

The necessity of early intraocular pressure measurement after intravitreal injection

作　　者：黄瑶 邵蕾 杨婧研 李培 魏文斌 Yao Huang;Lei Shao;Jingyan Yang;Pei Li;Wenbin Wei(Beijing Tongren Eye Center,Beijing key Laboratory of Intraocular Tumor Diagnosis and Treatment,Beijing Ophthalmology&Visual Sciences Key Lab.,Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心,眼内肿瘤诊治研究北京市重点实验室,北京市眼科学与视觉科学重点实验室,医学人工智能研究与验证工信部重点实验室,100730

出　　处：《中华眼科医学杂志（电子版）》2021年第6期353-358,共6页Chinese Journal of Ophthalmologic Medicine(Electronic Edition)

基　　金：首都卫生发展科研专项(首发2020-1-2052);北京市科委科技计划项目(Z201100005520045,Z181100001818003);中央保健科研课题(2020YB49)。

摘　　要：目的探讨玻璃体腔注药术后早期测量眼压的必要性。方法收集2021年7月22日至2021年8月31日于首都医科大学附属北京同仁医院眼科中心接受玻璃体腔注药手术的患者1018例(1193只眼)。其中,男性506例(597只眼),女性512例(596只眼);年龄9~99岁,平均年龄(60.2±13.9)岁。登记全部患者的性别、年龄、眼别、疾病种类及注射药物的品种,测量并记录其注药前后的眼压。年龄和眼压以±s描述。各眼压区段、各病种及各注药品种中患眼的分布情况采用眼数和百分比表示。以配对t检验比较各病种及各注药品种注药前后眼压的差异。结果全部1193只眼中,眼压术后30 min≤25mmHg(1 mmHg=0.133 kPa)者共计1183只眼,占99.16%。其中,糖尿病视网膜病变(DR)556只眼,占47.00%,湿性年龄相关性黄斑变性(AMD)304只眼,占25.70%,非湿性AMD的其他脉络膜新生血管(CNV)35只眼,占2.96%,视网膜静脉阻塞(RVO)247只眼,占22.81%,新生血管性青光眼(NVG)15只眼,占1.39%,其他疾病26只眼,占2.20%。眼压_(术后30 min)>25 mmHg者仅有10只眼。其中,眼压在26~30 mmHg者3只眼,眼压在31~40 mmHg者6只眼,眼压>40 mmHg者1只眼;病种为RVO者1只眼,DR1只眼,湿性AMD2只眼,NVG6只眼。此NVG6只眼的眼压术前为(43.67±8.71)mmHg。眼压_(术后30 min)>40 mmHg者仅有1只眼,使用降眼压药物30 min后眼压降为40 mmHg;其余NVG5只眼,眼压_(术后30 min)在26~40 mmHg之间。眼压_(术后30 min)>25 mmHg中另外非NVG的4只眼,继续观察30 min或60 min后,眼压均将至25 mmHg以下。玻璃体腔注射雷珠单抗和康柏西普的患眼眼压_(术前)分别为(15.51±4.71)mmHg和(15.03±3.79)mmHg;眼压_(术后30 min)分别为(17.00±4.81)mmHg和(16.62±4.14)mmHg。经配对t检验,两组术前与术后30 min眼压比较的差异具有统计学意义(t=-5.551,-6.187;P<0.05)。地塞米松玻璃体腔缓释植入剂玻璃体腔注射的患眼,眼压_(术前)为(14.80±2.59)mmHg,眼压_(术后30 min)为(14.80±2.59)mmHgObjective The aim of this study was to investigate the necessity of early intraocular pressure measurement after intravitreal injection.Methods From July 22 to August 31,2021,1018 consecutive patients(1193 eyes)who underwent intravitreal injection in Beijing Tongren Eye Center,Beijing Tongren Hospital Affiliated to Capital Medical University were collected.Among them,there were 506 male(597 eyes)and 512 female(596 eyes)with an average age of(60.2±13.9)years-old(ranged from 9 to 99 years-old).The gender,age,eye type,IOP,disease type and injected drugs of all patients were recorded.The intraocular pressure(IOP)before and after injection injection were measured.The data of age and IOP were expressed as±s.The overall number of eyes and the number of eyes of different diseases in each IOP segment are expressed in descriptive statistics and percentage.The difference of IOP before and after injection were used to compared by paired t test.Results After intravitreal injection for 30 mins,the IOP of 1183 eyes(99.16%)was less than or equal to 25 mmHg(1 mmHg=0.133 kPa).Among them,there were 556 eyes(47.00%)with diabetic retinopathy(DR),304 eyes(25.70%)with wet age-related macular degeneration(AMD),35 eyes(2.96%)with other choroidal neovascularization(CNV),247 eyes(22.81%)with retinal vein occlusion(RVO),15 eyes(1.39%)with neovascular glaucoma(NVG),and 26 eyes(2.20%)with other diseases.There were only 10 eyes with IOP over 25 mmHg,of which IOP of 3 eyes with 26 to 30 mmHg,6 eyes with 31 to 40 mmHg,and 1 eye with over 40 mmHg.There were one eye with RVO,one eye with DR,2 eyes with AMD,6 eyes with NVG.The IOP was(43.67±8.71)mmHg in 6 eyes with NVG before injection.There was IOP of 1 eye more than 40 mmHg after injection for 30 mins and IOP decreased to 40 mmHg after using IOP reducing drugs.IOP of 5 NVG eyes was 26~40 mmHg after injection for 30 mins.After observation for half an hour or 1 hour,the IOP of 4 eyes with non-NVG decreased to less than 25mmHg.For ranibizumab,conbercept injection,the IOP before injection were(15.

关 键 词：玻璃体腔注药 术后早期 眼压测量 必要性 

分 类 号：R779.6[医药卫生—眼科]