玻璃体腔内注射雷珠单抗联合532nm激光光凝治疗缺血型视网膜静脉阻塞患者的疗效观察
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摘要
目的:观察玻璃体腔内注射雷珠单抗联合532nm激光光凝治疗缺血型视网膜静脉阻塞(RVO)患者的短期疗效。方法:选取2015年10月至2017年10月我院缺血型RVO患者78例(78眼),依据简单随机分组法分为试验组39例(39眼)与对照组39例(39眼)。对照组予以532nm激光光凝治疗,试验组采取玻璃体腔内注射雷珠单抗联合532nm激光光凝治疗。治疗后进行6个月随访,比较两组临床效果、视网膜渗漏情况与治疗前、治疗后1个月、3个月、6个月最佳矫正视力(BCVA)、黄斑中心视网膜厚度(CMT)、生活质量评分(SF-36)。结果:治疗后6个月试验组总有效率94.87%较对照组76.92%高,差异有统计学意义(P<0.05);治疗后6个月试验组视网膜渗漏程度较对照组低,差异有统计学意义(P<0.05);治疗后1个月、3个月、6个月两组BCVA、SF-36评分均呈增高趋势,且试验组增高幅度较大,两组BCVA组间、不同时间点及组间·不同时间点交互作用相比,差异有统计学意义(P<0.05);治疗后1个月、3个月、6个月两组CMT呈降低趋势,且试验组降低幅度较大,两组CMT组间、不同时间点及组间·不同时间点交互作用相比,差异有统计学意义(P<0.05)。结论:缺血型视网膜静脉阻塞患者联合应用玻璃体腔内注射雷珠单抗与532nm激光光凝治疗可提升临床效果,提高视力,减轻视网膜渗漏及黄斑水肿,改善患者生活质量,近期疗效确切。
Objective: To observe the short-term efficacy of intravitreal injection of ranibizumab combined with 532 nm laser photocoagulation in patients with ischemic retinal vein occlusion(RVO). Methods: From October 2015 to October 2017, 78 patients(78 eyes) with ischemic RVO were enrolled. According to the random number table, 39 patients(39 eyes) and 39 patients(39 eyes) were included in the control group. The control group was treated with 532 nm laser photocoagulation. The experimental group was treated with intravitreal injection of ranibizumab plus 532 nm laser photocoagulation. Six-month follow-up after treatment was proceeded; the clinical effects, quality of life score(SF-36) retinal leakage and best corrected visual acuity(BCVA), macular central retinal thickness(CMT) during pre-treatment, 1 month, 3 months, 6 months after treatment were compared. Results: The total effective rate of the test group was 94.87% higher than that of the control group at 6 months after treatment, and the difference was statistically significant(P<0.05). The degree of retinal leakage in the test group was lower than that of the control group at 6 months after treatment. The difference was statistically significant. Significance(P<0.05); BCVA and SF-36 scores increased at 1 month, 3 months, and 6 months after treatment, and the test group increased significantly. The BCVA group and the different time points in the two groups. Compared with the interaction between groups and at different time points, the difference was statistically significant(P<0.05). The CMT of the two groups decreased at 1 month, 3 months and 6 months after treatment, and the test group decreased greatly. There was statistically significant difference between the two groups of CMT groups, at different time points, and between groups at different time points(P<0.05). Conclusion: Patients with ischemic retinal vein occlusion combined with intravitreal injection of ranibizumab and 532 nm laser photocoagulation can improve clinical outcomes, improve visual acuity, reduce retinal leakage and macular edema, and improve patients' quality of life.
Objective: To observe the short-term efficacy of intravitreal injection of ranibizumab combined with 532 nm laser photocoagulation in patients with ischemic retinal vein occlusion(RVO). Methods: From October 2015 to October 2017, 78 patients(78 eyes) with ischemic RVO were enrolled. According to the random number table, 39 patients(39 eyes) and 39 patients(39 eyes) were included in the control group. The control group was treated with 532 nm laser photocoagulation. The experimental group was treated with intravitreal injection of ranibizumab plus 532 nm laser photocoagulation. Six-month follow-up after treatment was proceeded; the clinical effects, quality of life score(SF-36) retinal leakage and best corrected visual acuity(BCVA), macular central retinal thickness(CMT) during pre-treatment, 1 month, 3 months, 6 months after treatment were compared. Results: The total effective rate of the test group was 94.87% higher than that of the control group at 6 months after treatment, and the difference was statistically significant(P<0.05). The degree of retinal leakage in the test group was lower than that of the control group at 6 months after treatment. The difference was statistically significant. Significance(P<0.05); BCVA and SF-36 scores increased at 1 month, 3 months, and 6 months after treatment, and the test group increased significantly. The BCVA group and the different time points in the two groups. Compared with the interaction between groups and at different time points, the difference was statistically significant(P<0.05). The CMT of the two groups decreased at 1 month, 3 months and 6 months after treatment, and the test group decreased greatly. There was statistically significant difference between the two groups of CMT groups, at different time points, and between groups at different time points(P<0.05). Conclusion: Patients with ischemic retinal vein occlusion combined with intravitreal injection of ranibizumab and 532 nm laser photocoagulation can improve clinical outcomes, improve visual acuity, reduce retinal leakage and macular edema, and improve patients' quality of life.
引文
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[9] 宋艳,蒋晨.雷珠单抗玻璃体内注射联合氩激光视网膜光凝治疗缺血型视网膜中央静脉阻塞及其并发症78例[J].中国药业,2014,23(13):84～85.
[2] 张敏,朱健华,冯浩,等.视网膜静脉阻塞合并黄斑水肿患者黄斑区微结构改变与视力的相关性分析[J].眼科新进展,2016,36(11):1061～1064.
[3] 许畅,黎智.视网膜中央静脉阻塞伴发黄斑水肿患者房水中sCD200、VEGF表达[J].临床眼科杂志,2017,25(6):488～493.
[4] 刘益帆,刘冬瑞,徐进,等.玻璃体注射雷珠单抗治疗老年性黄斑变性黄斑水肿与视网膜静脉阻塞性黄斑水肿的短期疗效观察[J].眼科,2017,26(2):120～124.
[5] Pielen A,Mirshahi A,Feltgen N,et al.Ranibizumab for branch retinal vein occlusion associated macular edema study(RABAMES):six-month results of a prospective randomized clinical trial[J].Acta Ophthalmol,2015,93(1):e29～e37.
[6] 陆慧琴,武炳慧,吴惠琴.玻璃体腔注射康柏西普治疗视网膜静脉阻塞并黄斑水肿[J].国际眼科杂志,2016,16(12):2264～2267.
[7] 张菁,蔡小军,陈晓敏,等.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继发黄斑水肿疗效观察[J].中华眼底病杂志,2015,31(1):22～26.
[8] Noma H,Mimura T,Yasuda K,et al.Role of soluble vascular endothelial growth factor receptors-1 and-2,their ligands,and other factors in branch retinal vein occlusion with macular edema[J].Invest Ophthalmol Vis Sci,2014,55(6):3878～3885.
[9] 宋艳,蒋晨.雷珠单抗玻璃体内注射联合氩激光视网膜光凝治疗缺血型视网膜中央静脉阻塞及其并发症78例[J].中国药业,2014,23(13):84～85.