地塞米松玻璃体内植入剂与雷珠单抗治疗视网膜静脉阻塞患者疗效及对MVD与FAZ的影响比较  

Comparison of the efficacy of dexamethasone intravitreal implant and ranibizumab in the treatment of patients with retinal vein occlusion and its impact on MVD and FAZ

作　　者：黄亮 徐标 周方兴 HUANG Liang;XU Biao;ZHOU Fangxing(Department of Ophthalmology,Aier Eye Hospital(Fuzhou),Jiangxi Province,Fuzhou 344000,China)

机构地区：[1]抚州爱尔眼科医院眼科,江西省抚州市344000

出　　处：《临床合理用药杂志》2024年第26期25-28,共4页Chinese Journal of Clinical Rational Drug Use

基　　金：抚州市社会发展指导性科技计划项目(20240138)。

摘　　要：目的 比较地塞米松玻璃体内植入剂与雷珠单抗治疗视网膜静脉阻塞(RVO)患者疗效及对黄斑区血流密度(MVD)与黄斑中心凹无血管区(FAZ)的影响。方法 选取2021年3月—2022年3月抚州爱尔眼科医院收治的RVO患者108例作为研究对象,以随机数字表法分为观察组和对照组,各54例。观察组予地塞米松玻璃体内植入治疗,对照组予雷珠单抗玻璃体内注射治疗。比较2组不同时点最佳矫正视力(BCVA)、黄斑中心凹厚度(CMT)、眼压,浅层毛细血管层(SCP)、深层毛细血管层(DCP)、脉络膜毛细血管层(CC)的MVD,FAZ面积及随访1年的复发情况。结果 治疗2周、1、3、6个月后,2组BCVA较治疗前升高,CMT较治疗前降低,且观察组治疗3、6个月后BCVA高于对照组,CMT低于对照组(P均<0.01);治疗2周、1、3、6个月后,对照组眼压与治疗前比较差异无统计学差异(P>0.05);治疗2周、1、3个月后,观察组眼压高于治疗前与同期对照组(P<0.05或P<0.01);2组治疗6个月后眼压比较无明显差异(P>0.05)。治疗前、治疗6个月后,2组SCP、DCP、CC层MVD及浅层与深层FAZ面积组内、组间比较差异均无统计学意义(P>0.05)。随访1年,观察组与对照组复发率(51.85%vs.55.56%)比较差异无统计学意义(χ^(2)=0.149,P=0.700)。观察组无复发持续时间为(6.75±0.43)月,长于对照组的(3.65±0.43)月(t=37.461,P<0.001)。结论 地塞米松玻璃体内植入剂与雷珠单抗治疗RVO均具有较佳疗效,地塞米松玻璃体内植入疗效持续时间较长,但治疗前期需密切监测眼压;2种治疗方法短期内对MVD、FAZ均无明显影响。Objective To compare the efficacy of dexamethasone intravitreal implant and ranibizumab in the treatment of patients with retinal vein occlusion(RVO) and its effect on macular blood flow density(MVD) and foveal avascular zone(FAZ).Methods A total of 108 patients with RVO admitted to Aier Eye Hospital(Fuzhou) from March 2021 to March 2022 were selected as the research objects and randomly divided into observation group and control group,with 54 cases in each group.The observation group was treated with dexamethasone intravitreal implant,and the control group was treated with ranibizumab intravitreal injection.The BCVA,CMT,intraocular pressure,MVD of SCP,DCP and CC,and FAZ area at different time points were compared between the two groups,as well as the recurrence after 1 year of follow-up.Results After treatments at 2 weeks,1 month,3 months,and 6 months,both groups showed an increase in BCVA and a decrease in CMT compared to pre-treatment.Moreover,the observation group had higher BCVA and lower CMT than the control group at 3 and 6 months post-treatment(P<0.01).The intraocular pressure of the control group after 2 weeks,1 month,3 months,and 6 months of treatment showed no statistically significant difference compared to before treatment(P>0.05).After 2 weeks,1 and 3 months of treatment,the intraocular pressure of the observation group were higher than that of the control group before treatment(P<0.05 or P<0.01).There was no significant difference in intraocular pressure between the two groups after 6 months of treatment(P>0.05).Before and 6 months after treatment,there were no significant differences in MVD of SCP,DCP and CC layer and FAZ area between shallow and deep layers between the two groups(P>0.05).After 1-year follow-up,there was no significant difference in the recurrence rate between the observation group and the control group(51.85% vs.55.56%)(χ^(2)=0.149,P=0.700).The duration of no recurrence in the observation group was(6.75±0.43) months,which was longer than(3.65±0.43) months in the control group(

关 键 词：视网膜静脉阻塞 地塞米松玻璃体内植入剂 雷珠单抗 

分 类 号：R779.6[医药卫生—眼科]