不同时机视网膜激光光凝辅助康柏西普治疗视网膜中央静脉阻塞继发黄斑水肿的疗效分析  

Clinical effect of retinal photocoagulation and conbercept in the treatment of macular edema secondary to central retinal vein occlusion at different times

作　　者：董立红[1] 张大传 DONG Lihong;ZHANG Dachuan(Department of Ophthalmology,Chaohu Hospital of Anhui Medical University,Chaohu 238000,Anhui Province,China;Department of Ophthalmology,the Third People’s Hospital of Hefei,Hefei 230000,Anhui Province,China)

机构地区：[1]安徽医科大学附属巢湖医院眼科,安徽省巢湖市238000 [2]安徽省合肥市第三人民医院眼科,安徽省合肥市230000

出　　处：《眼科新进展》2022年第7期546-550,共5页Recent Advances in Ophthalmology

摘　　要：目的分析不同时机的视网膜激光光凝辅助康柏西普治疗对视网膜中央静脉阻塞(CRVO)继发黄斑水肿(ME)患者疗效的影响。方法收集2017年6月至2019年6月于安徽医科大学附属巢湖医院眼科收治的101例(101眼)CRVO继发ME患者,按治疗情况分药物组(康柏西普治疗)、联合组A(康柏西普联合激光光凝治疗,病程<3个月)、联合组B(康柏西普联合激光光凝治疗,病程≥3个月),3组患者均按每月1次的频率接受3次玻璃体内注射康柏西普治疗,3次后接受按需治疗;联合组A、联合组B则在每次药物注射3 d后接受激光光凝治疗;比较3组患者康柏西普注射次数、视力、黄斑中心凹视网膜厚度(CMT)、视网膜出血吸收情况、无灌注区消退及新生血管情况。结果联合组A、联合组B患者康柏西普平均注射次数均显著低于药物组,但联合组A与联合组B患者间比较差异无统计学意义(P>0.05);联合组A、联合组B患者视力变化均优于药物组(均为P<0.001),且联合组A患者视力提高比例优于联合组B(P=0.027);联合组A、联合组B患者治疗后1个月、3个月、6个月、12个月时的CMT均显著高于药物组(均为P<0.05),但联合组A与联合组B患者间各时间点CMT相比差异均无统计学意义(均为P>0.05);联合组A、联合组B患者出血吸收情况及基于无灌区和新生血管情况的疗效等级均优于药物组(均为P<0.001),且联合组A患者的出血吸收情况及疗效等级均优于联合组B(均为P<0.05)。结论CRVO继发ME患者早期开展激光光凝治疗可获得更好的视力改善,出血吸收、无灌注区消退效果更佳,在抑制新生血管形成上优势更显著。Objective To analyze the clinical effect of retinal photocoagulation and conbercept in the treatment of macular edema(ME)secondary to central retinal vein occlusion(CRVO)at different times.Methods A total of 101 patients(101 eyes)with ME secondary to CRVO admitted to the Department of Ophthalmology,the Third People’s Hospital of Hefei,Anhui Province from June 2017 to June 2019 were enrolled and divided into the drug group(conbercept),combined group A(conbercept and laser photocoagulation,course of the disease<3 months),and combined group B(conbercept and laser photocoagulation,course of the disease≥3 months)according to the treatment.All patients were intravitreally injected with conbercept once a month for three months,and three months later,they were treated as needed.Patients in the combined groups A and B received laser photocoagulation on day 3 after each injection of conbercept.The number of conbercept injections,visual acuity,central macular thickness(CMT),absorption of retinal bleeding,regression in non-perfusion area(NPA),and neovascularization were compared among the three groups.Results The mean number of conbercept injections in the combined groups A and B was significantly less than that in the drug group,but there was no statistically significant difference between the combined groups A and B(P>0.05).The visual acuity of patients in the combined groups A and B was better than that in the drug group(P<0.001),and the visual acuity in the combined group A was better than that in the combined group B(P=0.027).CMT at 1 month,3 months,6 months and 12 months after treatment in the combined groups A and B was significantly higher than that in the drug group(all P<0.05),but there was no statistically significant difference between the combined groups A and B(all P>0.05).Bleeding absorption and curative effects based on NPA and neovascularization in the combined groups A and B were better than those in the drug group(all P<0.001).Bleeding absorption and curative effects based on NPA and neovascularization

关 键 词：视网膜中央静脉阻塞 黄斑水肿 激光光凝 康柏西普 

分 类 号：R774[医药卫生—眼科]