摘要
目的 观察玻璃体腔注射康柏西普联合视网膜激光光凝治疗视网膜分支静脉阻塞（BRVO）继发黄斑水肿的疗效.方法 临床检查确诊的BRVO继发黄斑水肿患者38例38只眼纳入研究.所有患者均行最佳矫正视力（BCVA）、裂隙灯显微镜联合78D前置镜、眼压、光相干断层扫描、荧光素服底血管造影检查.依据就诊顺序按照随机排列表方法随机将患者分为康柏西普＋激光组（CL组）、曲安奈德（TA）＋激光组（TL组）、激光组（L组）,分别为14、13、11只眼.CL组、TL组玻璃体腔分别注入雷珠单抗0.05 ml（含康柏西普0.5 mg）和TA 0.10 ml（含TA 4.0 mg）;L组行单纯视网膜激光光凝治疗.3组间BCVA（F=0.003）、黄斑中心视网膜厚度（CMT） （F=0.002）比较,差异无统计学意义（P＞0.05）.对比观察3组间治疗后1d,1周,1、3个月患眼BCVA和（CMT）的变化情况.同时观察与药物和治疗方式相关的眼部和全身不良反应发生情况.结果 治疗后1d,1周,1、3个月,3组间BCVA提高、稳定、下降眼数（χ^2=9.754、12.430、17.424、13.189）比较,差异均有统计学意义（P＜0.05）.组间两两比较,CL组BCVA提高及稳定眼数明显多于L组,差异均有统计学意义（χ^2=9.339、11.414、14.528、10.319,P＜0.01）;与TL组比较,差异无统计学意义（x2=1.439、1.060、0.479、0.016,P＞0.05）.3组间不同观察时间点平均CMT（F=10.614、4.099、4.927、8.99）比较,差异均有统计学意义（P＜0.05）.CL组治疗后不同观察时间点平均CMT均较L组降低,差异有统计学意义（t=3.967、2.836、2.095、4.223,P＜0.05）;CL组与TL组比较,治疗后3个月时,差异有统计学意义（t=2.128,P＜0.05）;1 d,1周,1个月时,差异均无统计学意义（t=0.075、0.020、0.079,P＞0.05）.CL组未见与药物、玻璃体腔注射相关的眼部和全身不良反应发生.TL组眼压升高1只眼,局部应用降眼压药物后,眼压恢复正常.结论 玻璃体腔注射康柏西普联合视网膜激光光凝疗效优于单纯激光光凝;治疗后3个月较玻璃体腔注射TA联合激光光凝治疗能保持更强的促进水肿吸收的作用.
Objective To investigate the effects and safety of intravitreous injection of Conbercept combined with laser photocoagulation for macular edema secondary to branch retinal vein occlusion.Methods All subjects were assigned randomly to 3 groups：intravitreal Conbercept combined with laser photocoagulation group （CL group）,intravitreal triamcinolone combined with laser photocoagulation group （TL group）,and photocoagulation group （L group）.The best-corrected visual acuity （BCVA）,central macular thickness （CMT）,fundus oculi and fundus fluorescein angiography （FFA）,intraocular pressure （IOP）,slit lamp were observed before and 1 day,1 week,1 month,3 months after treatment.The changes of post-treatment BCVA and CMT in pre-therapy and post-treatment were compared,and related complications were recorded.Results There were significant differences of BCVA （χ^2=9.754,12.430,17.424,13.189） and CMT （F=10.614,4.099,4.927,8.99） between 3 groups in post-treatment 1 day,1 week,1 month and 3 months.The numbers of subjects of improving and stabilizing BCVA in CL group were remarkably more than that in L group in every post-treatment follow-up time （P〈0.01）,whereas the CMTs in CL group were significantly less than that in L group in every post treatment follow up time （P〈 0.05）.The CMTs in post-treatment 1 day,1 week,1 month,3 months were thinner than that in pretreatment in CL group and TL group （P〈0.05）.Meanwhile,there was no significant difference （P〉 0.05） between any two CMTs in post-treatment 1 day,1 week,1 month and 3 months in CL group.Yet,the CMT in post-treatment 3 months was thicker than those in post-treatment 1 day,1 week and 1 month in TL group （P〈 0.05）.And there was no significant difference （P〉 0.05） between any two CMTs in post-treatment 1 day,1 week and 1 month in TL group.There was no conspicuous difference in CMTs（P〉 0.05） between in CL group and in TL group in every viewing time,except for that in post treatment 3 months（P〈0.05）.There was only 1 case of intraocular hypertension in post-treatment in TL group.Conclusions Intravitreous injection of Conbercept combined with laser photocoagulation for macular edema secondary to BRVO is effective,safe,and superior to laser photocoagulation only.Also it had a longer effective duration and less complications than intravitreal triamcinolone combined with laser photocoagulation.
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2015年第1期22-26,共5页
Chinese Journal of Ocular Fundus Diseases
