地塞米松缓释剂玻璃体腔内注射在特发性黄斑前膜患者中的应用效果  

Application effect of intravitreal injection of Dexamethasone Sustained Release Agent in patients with idiopathic macular epiretinal membrane

作　　者：王爱芹 许澈 赵思婕 WANG Aiqin;XU Che;ZHAO Sijie(Department of Ophthalmology,The First Affiliated Hospital of Bengbu Medical University,Anhui Province,Bengbu 233000,China)

机构地区：[1]蚌埠医科大学第一附属医院眼科,安徽蚌埠233000

出　　处：《中国当代医药》2024年第36期54-57,65,共5页China Modern Medicine

基　　金：蚌埠医学院自然科学重点项目(2022byzd062)。

摘　　要：目的 探讨地塞米松缓释剂玻璃体腔内注射在特发性黄斑前膜(IMEM)患者中的应用效果。方法 回顾性分析2023年1月至2024年1月蚌埠医科大学第一附属医院收治的65例IMEM患者的资料,根据治疗方法分为对照组(n=35)与研究组(n=30)。对照组采用玻璃体切除联合内界膜剥除术治疗,研究组在对照组基础上加用地塞米松玻璃体内植入剂。比较两组患者术眼最佳矫正视力(BCVA)、黄斑中心凹视网膜厚度(CMT)、异常中心凹内层(EIFL)厚度、血清指标及并发症发生情况。结果 两组患者术前最小分辨角对数视力(logM AR)、CMT和EIFL厚度比较,差异无统计学意义(P>0.05);术后不同时间点,研究组logM AR、CMT、EIFL厚度、术后并发症总发生率均低于对照组,差异有统计学意义(P<0.05)。术前,两组患者血管内皮生长因子(VEGF)、低氧诱导因子(HIF-1α)水平比较,差异无统计学意义(P>0.05);术后,两组患者VEGF、HIF-1α水平均低于本组术前,且研究组VEGF、HIF-1α水平低于对照组,差异有统计学意义(P<0.05)。结论 在玻璃体切除联合内界膜剥除术治疗基础上,加用地塞米松玻璃体内植入剂治疗利于改善IMEM患者BCVA、CMT,降低VEGF、HIF-1α水平,降低EIFL厚度,减少并发症发生,值得推广应用。Objective To investigate the application effect of intravitreal injection of Dexamethasone Sustained Release Agent in patients with idiopathic macular epiretinal membrane(IMEM).Methods The data of 65 patients with IMEM admitted to The First Affiliated Hospital of Bengbu Medical University from January 2023 to January 2024 were retrospectively analyzed and they were divided into control group(n=35)and study group(n=30)according to treatment methods.The control group was treated with vitrectomy combined with inner boundary membrane stripping,and the study group was treated with Dexamethasone Intravitreal Implant on the basis of control group.The best corrected visual acuity(BCVA),central macular thickness(CMT),ectopic inner foveal lager(EIFL)thickness,serum indexes and complications were compared between the two groups.Results There were no significant differences in logarithm of the minimum angle of resolution vision(logMAR),CMT and EIFL thickness before and after surgery between the two groups(P>0.05).At different time points after surgery,logMAR,CMT,EIFL thickness,and the total incidence of postoperative complications in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).Before surgery,there were no significant differences in the levels of vascular endothelial growth factor(VEGF)and hypoxia inducible factor-1α(HIF-1α)between two groups(P>0.05).After surgery,the levels of VEGF and HIF-1αin two groups were lower than those before surgery,and the levels of VEGF and HIF-1αin the study group were lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion On the basis of vitrectomy combined with inner boundary membrane stripping,Dexamethasone Intravitreal Implant therapy can improve BCVA and CMT in IMEM patients,reduce VEGF and HIF-1αlevels,reduce EIFL thickness,and reduce complications,which is worthy of promotion and application.

关 键 词：特发性黄斑前膜 玻璃体腔内注射 地塞米松缓释剂 最佳矫正视力 并发症 

分 类 号：R774.5[医药卫生—眼科]