阿柏西普与地塞米松缓释植入物治疗视网膜中央静脉阻塞继发黄斑水肿的短期疗效对比  

Short-term efficacy comparison of intravitreal aflibercept and dexamethasone sustained-release implantin on macular edema secondary to central retinal vein occlusion

作　　者：刘玉辉 王蓓[1] 刘刚 Liu Yuhui;Wang Bei;Liu Gang(Department of Ophthalmology,Nanjing Lishui People's Hospital,Zhongda Hospital Lishui Branch,Southeast University,Nanjing 211200,China)

机构地区：[1]南京市溧水区人民医院,东南大学附属中大医院溧水分院眼科,南京211200

出　　处：《眼科》2023年第3期197-201,共5页Ophthalmology in China

基　　金：江苏大学临床医学科技发展基金(自然科学类)重点项目(JLY20180034)。

摘　　要：目的 对比分析阿柏西普与地塞米松缓释植入物治疗视网膜中央静脉阻塞(CRVO)继发黄斑水肿(ME)的短期临床疗效。设计回顾性病例系列。研究对象选取2018年10月至2021年6月就诊于南京市溧水区人民医院的CRVO-ME患者36例。方法根据治疗药物不同,分为阿柏西普组(玻璃体注射阿柏西普0.5 mg,17例17眼)和地塞米松缓释植入物组(DEX组,玻璃体注射地塞米松缓释植入物0.7 mg,19例19眼)。对比分析两组间术前、术后1、2、3、6个月的临床资料,包括最佳矫正视力(BCVA)、浆液性视网膜脱离高度(SRDH)、视网膜中央厚度(CRT)、光感受器层厚度(PLT)、眼压(IOP)。主要指标BCVA、SRDH、CRT、PLT和IOP。结果两组患者术前BCVA、SRDH、CRT、PLT、IOP比较均无统计学差异(P均>0.05)。术后1个月,两组的BCVA,SRDH、CRT、PLT均优于术前(P均<0.05),两组间比较无统计学差异(P均>0.05)。术后2、3个月,DEX组的SRDH均明显低于阿柏西普组(P=0.021、0.017),两组间BCVA、CRT和PLT均无明显统计学差异(P均>0.05)。术后6个月,阿柏西普组的CRT低于DEX组,PLT明显高于DEX组,BCVA优于DEX组(P=0.005、0.029、0.036),两组间SRDH比较无统计学差异(P=0.054)。结论阿柏西普和地塞米松缓释植入物治疗CRVO-ME临床疗效均确切,可显著改善患者SRDH、CRT和视力获益。地塞米松缓释植入物在消退SRD方面短期疗效更佳,治疗间隔延长,而阿柏西普在治疗期间能更好地维持患者良好视力。Objective To compare and analyze the short-term clinical efficacy of intravitreal aflibercept and dexamethasone(DEX)sustained-releaseimplant on macular edema(ME)secondary to central retinal vein occlusion(CRVO).Design Retrospective case series.Participants Thirty-six patients diagnosed with CRVO-ME in Nanjing Lishui People's Hospital from October 2018 to June 2021.Methods According to different therapeutic drugs,two groups were divided:aflibercept group(intravitreal aflibercept 0.5 mg)17 cases(17 eyes),and DEX group(intravitreal DEX sustained-releaseimplant 0.7 mg)19 cases(19 eyes).Clinical data between the two groups before surgery and 1,2,3,and 6 months after surgery,including best corrected visual acuity(BCVA),serous retinal detachment height(SRDH),central retinal thickness(CRT),photoreceptor layer thickness(PLT),and intraocular pressure(IOP)were analyzed.Main Outcome Measures BCVA,SRDH,CRT,PLT,IOP.Results There was no statistically significant difference in preoperative BCVA,SRDH,CRT,PLT,and IOP between the two groups(all P>0.05).One month after surgery,the BCVA,SRDH,CRT,and PLT of the two groups were better than before surgery(all P<0.05),and there was no statistically significant difference between the two groups(all P>0.05).At 2 and 3 months after surgery,the SRDH in the DEX group was significantly lower than that of the aflibercept group(P=0.021,0.017,respectively),however,there was no significant statistical difference in BCVA,CRT,and PLT between the two groups(all P>0.05).At 6 months after surgery,the CRT in the aflibercept group was lower than that of the DEX group,the PLT was significantly higher than that of the DEX group,and the BCVA was better than that of the DEX group(P=0.005,0.029,0.036,respectively).There was no statistically significant difference in SRDH between the two groups(P=0.054).Conclusion Intravitreal aflibercept and DEX were proven effective for the patients with CRVO-ME,which significantly improve SRDH and CRT,and achieve visual benefits.Intravitreal DEX has better short-term effica

关 键 词：视网膜中央静脉阻塞 黄斑水肿 地塞米松缓释植入物 阿柏西普 

分 类 号：R774.5[医药卫生—眼科]