西藏拉萨地区抗血管内皮生长因子药物治疗视网膜分支静脉阻塞继发黄斑水肿的初步结果  

Preliminary results of anti-vascular endothelial growth factor treatment for macular edema secondary to branch retinal vein occlusion in Lhasa Tibet

作　　者：斯娜卓嘎 德吉央宗[1] 安芳[1] 央珍[1] 小达娃[1] 次仁琼达 陈小蓉 赵明威[2] 苗恒 Sina Zhuoga;Deji Yangzong;An Fang;Yang Zhen;Xiao Dawa;Chen Qionga;Chen Xiaorong;Zhao Mingwei;Miao Heng(Department of Ophthalmology,Tibet Autonomous Region People's Hospital,Lhasa 850000,China;Department of Ophthalmology&Clinical center of Optometry,Peking University People's Hospital,Eye Diseases and Optometry Institute,Beijing Key Laboratory Diagnosis and Therapy of Retina and Choroid Diseases,College of Optometry,Peking University Health Science Center,Beijing 100044,China)

机构地区：[1]西藏自治区人民医院眼科,拉萨850000 [2]北京大学人民医院眼科、眼视光中心眼病与视光医学研究所视网膜脉络膜疾病诊治研究北京市重点实验室北京大学医学部眼视光学院,北京100044

出　　处：《中华眼底病杂志》2023年第5期375-380,共6页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的观察并初步评价抗血管内皮生长因子(VEGF)药物治疗西藏拉萨地区视网膜分支静脉阻塞(BRVO)继发黄斑水肿(ME)患眼的安全性和有效性。方法回顾性病例系列研究。2018年9月至2022年1月于西藏自治区人民医院眼科检查确诊的BRVO继发ME患者41例41只眼纳人研究。其中,男性21例21只眼,女性20例20只眼;中位年龄53(31,75)岁。合并高血压病者24例(58.8%,24/41)。患眼均行最佳矫正视力(BCVA)、眼压、眼底彩色照相、光相干断层扫描(OCT)检查。BCVA检查采用国际标准对数视力表进行,统计时换算为最小分辨角对数(logMAR)视力;OCT仪测量中心凹视网膜厚度(CMT)。所有患眼均行玻璃体腔注射抗VEGF药物治疗,每一个月1次,其中玻璃体腔注射雷珠单抗(IVR)、康柏西普(IVC)分别为23例23只眼(56.1%,23/41)、18例18只眼(43.9%,18/41),并据此分组。两组患者年龄(Z=-0.447)、性别构成(Z=0.485)、1ogMARBCVA(t=-1.591)、眼压(t=-0.167)、CMT(-1.290)比较,差异无统计学意义(P>0.05)。治疗后随访时间89(35,198)d;IVR组、IVC组随访时间分别为85(35,185)、120(43,263)d,差异无统计学意义(Z=-1.289,P>0.05)。随访时采用基线时相同设备和方法行相关检查,对比观察基线及末次随访时患眼BCVA、眼压、CMT变化以及新发心脑血管性事件。基线与末次随访时logMARBCVA、眼压、CMT比较采用Studentt检验;IVR组、IVC组组间注药次数、随访时间比较采用Mann-Whitney U检验。结果基线时,患眼logMARBCVA、眼压、CMT分别为0.852±0.431、(12.5±2.5)mmHg(1mmHg=0.133kPa)、(578.1±191.1)μm。末次随访时,患眼抗VEGF药物治疗次数为(2.7±1.2)次;logMARBCVA、CMT分别为0.488±0.366、(207.4±108.7)μm,其中CMT仍>250μm者14只眼(34.1%,14/41)。与基线时比较,BCVA(t=4.129)、CMT(-0.713)均显著改善,差异有统计学意义(P<0.001)。IVR组、IVC组注药次数分别为(2.6±0.9)、(3.0±1.5)次;两组患眼注药次数(t=-1.275)、1ogMARBCVA(=-0.492)、�Objective To observe and evaluate the safety and efficacy of anti-vascular endothelial growth factor(VEGF)in the treatment of eyes with macular edema(ME)secondary to branch retinal vein occlusion(BRVO)in Lhasa,Tibet.Methods A retrospective case series.From September 2018 to January 2022,a total of 41 patients(41 eyes)with BRVO-ME,who were diagnosed in Department of Ophthalmology of Tibet Autonomous Region People's Hospital,were included in this study.There were 21 eyes in 21 males and 20 eyes in 20 females.The median age was 53(31,75)years.There were 24 patients with hypertension(58.8%,24/41).Best corrected visual acuity(BCVA),ocular pressure,fundus color photography and optical coherence tomography(OCT)were performed in all eyes.The BCVA was performed using the international standard logarithmic visual acuity chart,which was converted into logarithm of the minimum angle of resolution(logMAR)BCVA for record.The foveal macular thickness(CMT)was measured by OCT.All eyes were treated with intravitreous injection of anti-VEGF drugs,once a month,among which 23 eyes(56.1%,23/41)received intravitreous injection of ranibizumab(1VR),and 18 eyes(43.9%,18/41)received intravitreous injection of conbercept(IVC),and were grouped accordingly.There was no significant difference in age(Z=-0.447),gender composition(Z=-0.485),logMAR BCVA(t=-1.591),intraocular pressure(t=-0.167)and CMT(t=-1.290)between two groups(P>0.05).During the follow-up,the same devices and methods were used at baseline to perform relevant examinations,and the changes of BCVA,intraocular pressure,CMT and new cardiovascular and cerebrovascular events were compared between baseline and the last follow-up.logMAR BCVA,intraocular pressure and CMT were compared between baseline and last follow-up using Student t test.The comparison of injection times and follow-up time between IVR group and IVC group was conducted by Mann-Whitney U test.Results At baseline,logMAR BCVA,intraocular pressure,and CMT were 0.852±0.431,(12.5±2.5)mm Hg(1 mm Hg=0.133 kPa),and(578.1±191.1

关 键 词：西藏 抗血管内皮生长因子药物治疗 视网膜分支静脉阻塞 黄斑水肿 

分 类 号：R774.1[医药卫生—眼科]