经巩膜视网膜下液引流及冷凝术联合康柏西普治疗3期外层渗出性视网膜病变疗效观察  

Efficacy of transscleral subretinal fluid drainage and cryotherapy combined with conberceptin treatment for stage 3 Coats disease

作　　者：赵珂珂 姚腾腾 杨帅[2] 邱要颜 汪朝阳 张聪慧 ZHAO Ke-ke;YAO Teng-teng;YANG Shuai;QIU Yao-yan;WANG Zhao-yang;ZHANG Cong-hui(Department of Ophthalmology,Shanghai Children’s Medical Center,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China;Department of Ophthalmology,Tenth People’s Hospital of Tongji University,Shanghai 200072,China)

机构地区：[1]上海交通大学医学院附属上海儿童医学中心眼科,上海200127 [2]同济大学附属第十人民医院眼科,上海200072

出　　处：《海军军医大学学报》2022年第7期832-836,共5页Academic Journal of Naval Medical University

摘　　要：目的观察经巩膜视网膜下液引流及冷凝术联合玻璃体内注射抗血管内皮生长因子(VEGF)药康柏西普对3期外层渗出性视网膜病变的疗效。方法回顾性分析11例(11眼)3期外层渗出性视网膜病变患者的临床资料。患者年龄2~16岁,男10例、女1例;3A期(视网膜次全脱离)7眼,3B期(视网膜全脱离)4眼。所有患眼均接受经巩膜视网膜下液引流及视网膜异常血管冷凝术,联合玻璃体内注射抗VEGF药康柏西普。术后随访6~20个月,主要疗效指标为最佳矫正视力、眼压和视网膜复位情况。结果9例患者视网膜完全复位,2例仍有渗出性视网膜脱离。末次随访时,11例患者中视力提高8例,视力无变化1例,视力下降1例,视力检查不配合1例。随访期间新发生斜视1例(患者年龄小、视力差),未观察到手术操作相关的并发症。结论经巩膜视网膜下液引流及冷凝术联合玻璃体内注射抗VEGF药康柏西普是治疗3期外层渗出性视网膜病变的一种有效方法,能有效复位视网膜、挽救视功能。Objective To observe the efficacy of transscleral subretinal fluid drainage and cryotherapy combined with intravitreal injection of conbercept,an anti-vascular endothelial growth factor (VEGF) drug,in the treatment of stage 3Coats disease.Methods The clinical data of 1l patients (11 eyes) with stage 3 Coats disease were analyzed retrospectively.The patients were aged 2-16 years old,with 10 boys and 1 girl;7 eyes with partial retinal detachment (stage 3A) and 4 eyes with complete retinal detachment (stage 3B).All eyes were treated with transscleral subretinal fluid drainage and retinal cryotherapy combined with intravitreal injection of conbercept (an anti-VEGF drug).The patients were followed up for6-20 months.The main efficacy indexes were the best corrected visual acuity,intraocular pressure,and retinal reattachment.Results The retina was completely reattached in 9 eyes and exudative retinal detachment was found in 2 eyes.At the end of follow-up,among the 11 cases,visual acuity was improved in 8 eyes,unchanged in 1 eye,decreased in 1 eye,and 1 case failed to cooperate with the examination.Strabismus occurred newly in 1 eye (the patient was young with poor eyesight) during the follow-up.No complications related to the operation were observed.Conclusion Transscleral subretinal fluid drainage and cryotherapy combined with intravitreal injection of anti-VEGF drug conbercept is an effective method for the treatment of stage 3 Coats disease,and it can achieve the retina reattachment in most patients and effectively rescue the visual function.

关 键 词：视网膜下液 冷凝术 血管内皮生长因子 外层渗出性视网膜病变 

分 类 号：R774.1[医药卫生—眼科]