近5a视网膜静脉阻塞临床特点的回顾性分析
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摘要
目的:回顾分析5a内佛山市第二人民医院眼科中心视网膜静脉阻塞的临床诊治变化。方法:回顾性分析2013-01-01/2017-12-31于我院眼科中心的住院患者,以诊断"视网膜静脉阻塞"为检索词查阅病历信息管理系统,就其相关住院诊治情况作统计分析。结果:5a内视网膜静脉阻塞的住院患者共351例,住院次数473人次,伴随全身疾病(高血压、糖尿病、肾功能不全)的老年人常见;住院天数各年度间有差异,2017年较前明显缩短。5a间RVO的发病人数逐年上升,BRVO较CRVO的发病趋势增加明显,2017年两种疾病的发病比率与各年度间均有差异(P<0.005)。RVO主要采用视网膜激光光凝、玻璃体腔内注药或两者相结合的治疗方案。5a内玻璃体腔内注药治疗的注射率有差异(P<0.05),主要表现为2013年的低注射率;"1+PRN"的注射方案多于"3+PRN"。结论:近5a BRVO较CRVO的增长趋势更明显,激光联合"1+PRN"的玻璃体腔内注药方案是我院RVO患者的主要治疗手段。
AIM: To retrospectively analyze the clinical change of retinal vein occlusion inpatients of the Second People's Hospital of Foshan in the nearby five years.METHODS: The data of inpatients in the Second People's Hospital of Foshan were collected by the term "retinal vein occlusion"from 2013-01-01 to 2017-12-31. Retrospective analysis of the details for the disease.RESULTS: Totally 351 patients with retinal vein occlusion were admitted and treated for 473 times in five years. Elder with systemic disease(hypertension, diabetes and renal inadequacy) was more common. The hospital days were significantly statistical difference among five years with the shortest days in 2017. The prevalence of RVO was growing year by year, especially for BRVO, with statistical difference between 2017 and the other four years(P<0.005). Treatments for RVO were mainly including retinal laser, intravitreal injection or both combined. There was significantly statistical difference about the rate of intravitreal injection among five years(P<0.05) with the lowest one in 2013."1+PRN" therapeutic regimen was more tolerable for patients than "3+PRN".CONCLUSION: BRVO is growing more sharply than CRVO in the nearby five years. Retinal laser combined with"1+PRN"intravitreal injection is the main therapeutic regimen for RVO in our hospital.
AIM: To retrospectively analyze the clinical change of retinal vein occlusion inpatients of the Second People's Hospital of Foshan in the nearby five years.METHODS: The data of inpatients in the Second People's Hospital of Foshan were collected by the term "retinal vein occlusion"from 2013-01-01 to 2017-12-31. Retrospective analysis of the details for the disease.RESULTS: Totally 351 patients with retinal vein occlusion were admitted and treated for 473 times in five years. Elder with systemic disease(hypertension, diabetes and renal inadequacy) was more common. The hospital days were significantly statistical difference among five years with the shortest days in 2017. The prevalence of RVO was growing year by year, especially for BRVO, with statistical difference between 2017 and the other four years(P<0.005). Treatments for RVO were mainly including retinal laser, intravitreal injection or both combined. There was significantly statistical difference about the rate of intravitreal injection among five years(P<0.05) with the lowest one in 2013."1+PRN" therapeutic regimen was more tolerable for patients than "3+PRN".CONCLUSION: BRVO is growing more sharply than CRVO in the nearby five years. Retinal laser combined with"1+PRN"intravitreal injection is the main therapeutic regimen for RVO in our hospital.
引文
1 Rogers S, McIntosh RL, Cheung N, et al. The prevalence of retinal vein occlusion: pooled data from population studies from the United States, Europe, Asia, and Australia. Ophthalmology 2010;117(2):313-319
2周金琼,徐亮,王爽. 视网膜静脉阻塞的流行病学研究现状. 国际眼科纵览 2011;35(6):374-378
3刘伟伟, 徐亮. 视网膜静脉阻塞的流行病学调查. 国际眼科纵览 2007;31(1):13-17
4 Rehak M, Wiedemann P. Retinal vein thrombosis: pathogenesis and management. J Thromb Haemost 2010;8(9):1886-1894
5 Keel S, Xie J, Foreman J, et al. Prevalence of retinal vein occlusion in the Australian National Eye Health Survey. Clin Exp Ophthalmol 2018;46(3):260-265
6 Ponto KA, Elbaz H, Peto T, et al. Prevalence and risk factors of retinal vein occlusion:the Gutenberg Health Study. J Thromb Haemost 2015;13(7):1254-1263
7 Thapa R, Bajimaya S, Paudyal G, et al. Prevalence, pattern and risk factors of retinal vein occlusion in an elderly population in Nepal: the Bhaktapur retina study. BMC Ophthalmol 2017;17(1):162
8 Arnarsson A, Stefansson E. Laser treatment and the mechanism of edema reduction in branch retinal vein occlusion. Invest Ophthalmol Vis Sci 2000;41(3):877-879
9 Brown DM, Campochiaro PA, Singh RP, et al. Ranibizumab for macular edema following central retinal vein occlusion: six-month primary end point results of a phase III study. Ophthalmology 2010;117(6):1124-1133
10 Campochiaro PA, Heier JS, Feiner L, et al. Ranibizumab for macular edema following branch retinal vein occlusion: six-month primary end point results of a phase III study. Ophthalmology 2010;117(6):1102-1112
11林国乔,郑德志, 陈伟奇. 康柏西普治疗视网膜分支静脉阻塞(BRVO)继发黄斑水肿的临床研究. 眼科新进展 2018;38(11):1055-1058
12 Mandelcorn MS,Nrusimhadevara RK. Internal limiting membrane peeling for decompression of macular edema in retinal vein occlusion:a report of 14 cases. Retina 2004;24(3):348-355
13 Noma H,Funatsu H,Yamasaki M,et al. Pathogenesis of macular edema with branch retinal vein occlusion and intraocular levels of vascular endothelial growth factor and interleukin-6. Am J Ophthalmol 2005;140(2):256-261
14 Funk M,Kriechbaum K,Prager F,et al. Intraocular concentrations of growth factors and cytokines in retinal vein occlusion and the effect of therapy with bevacizumab. Invest Ophthalmol Vis Sci 2009;50(3):1025-1032
15 Coscas G,Augustin A,Bandello F,et al. Retreatment with Ozurdex for macular edema secondary to retinal vein occlusion. Eur J Ophthalmol 2014;24(1):1-9
16 Tservakis I,Koutsandrea C,Papaconstantinou D,et al. Safety and efficacy of dexamethasone intravitreal implant (Ozurdex) for the treatment of persistent macular edema secondary to retinal vein occlusion in eyes previously treated with anti-vascular endothelial growth factors. Curr Drug Saf 2015;10(2):145-151
17 Chen SD, Sundaram V, Lochhead J, et al. Intravitreal triamcinolone for the treatment of ischemic macular edema associated with branch retinal vein occlusion. Am J Ophthalmol 2006;141(5):876-883
18 Braithwaite T,Nanji AA,Greenberg PB. Anti-vascular endothelial growth factor for macular edema secondary to central retinal vein occlusion. Cochrane Database Syst Rev 2010;10:CD007325
19 Feng XX, Li C, Shao WW, et al. Intravitreal anti-VEGF agents, oral glucocorticoids, and laser photocoagulation combination therapy for macular edema secondary to retinal vein occlusion: preliminary report. Int J Ophthalmol 2018;11(3):429-437
20 Karagiannis DA, Karampelas MD, Soumplis VM, et al. Recurrence of macular edema in retinal vein occlusions after treatment with intravitreal ranibizumab (Lucentis). Can J Ophthalmol 2011;46(6):486-490
21 Miwa Y,Muraoka Y,Osaka R,et al. Ranibizumab for macular edema after branch retinal vein occlusion:One Initial Injection Versus Three Monthly Injections. Retina 2017;37(4):702-709
22 Ito Y, Saishin Y, Sawada O, et al. Comparison of single injection and three monthly injections of intravitreal bevacizumab for macular edema associated with branch retinal vein occlusion. Clin Ophthalmol 2015;9:175-180
23 Ahn SJ, Ahn J, Woo SJ, et al. Initial dose of three monthly intravitreal injections versus PRN intravitreal injections of bevacizumab for macular edema secondary to branch retinal vein occlusion. Biomed Res Int 2013;2013:209735
24蔡骐, 周跃, 黄黎黎, 等. 康柏西普治疗视网膜分支静脉阻塞继发黄斑水肿. 国际眼科杂志 2018;18(5):922-925
25 London NJ,Chiang A,Haller JA. The dexamethasone drug delivery system: indications and evidence. Adv Ther 2011;28(5):351-366
2周金琼,徐亮,王爽. 视网膜静脉阻塞的流行病学研究现状. 国际眼科纵览 2011;35(6):374-378
3刘伟伟, 徐亮. 视网膜静脉阻塞的流行病学调查. 国际眼科纵览 2007;31(1):13-17
4 Rehak M, Wiedemann P. Retinal vein thrombosis: pathogenesis and management. J Thromb Haemost 2010;8(9):1886-1894
5 Keel S, Xie J, Foreman J, et al. Prevalence of retinal vein occlusion in the Australian National Eye Health Survey. Clin Exp Ophthalmol 2018;46(3):260-265
6 Ponto KA, Elbaz H, Peto T, et al. Prevalence and risk factors of retinal vein occlusion:the Gutenberg Health Study. J Thromb Haemost 2015;13(7):1254-1263
7 Thapa R, Bajimaya S, Paudyal G, et al. Prevalence, pattern and risk factors of retinal vein occlusion in an elderly population in Nepal: the Bhaktapur retina study. BMC Ophthalmol 2017;17(1):162
8 Arnarsson A, Stefansson E. Laser treatment and the mechanism of edema reduction in branch retinal vein occlusion. Invest Ophthalmol Vis Sci 2000;41(3):877-879
9 Brown DM, Campochiaro PA, Singh RP, et al. Ranibizumab for macular edema following central retinal vein occlusion: six-month primary end point results of a phase III study. Ophthalmology 2010;117(6):1124-1133
10 Campochiaro PA, Heier JS, Feiner L, et al. Ranibizumab for macular edema following branch retinal vein occlusion: six-month primary end point results of a phase III study. Ophthalmology 2010;117(6):1102-1112
11林国乔,郑德志, 陈伟奇. 康柏西普治疗视网膜分支静脉阻塞(BRVO)继发黄斑水肿的临床研究. 眼科新进展 2018;38(11):1055-1058
12 Mandelcorn MS,Nrusimhadevara RK. Internal limiting membrane peeling for decompression of macular edema in retinal vein occlusion:a report of 14 cases. Retina 2004;24(3):348-355
13 Noma H,Funatsu H,Yamasaki M,et al. Pathogenesis of macular edema with branch retinal vein occlusion and intraocular levels of vascular endothelial growth factor and interleukin-6. Am J Ophthalmol 2005;140(2):256-261
14 Funk M,Kriechbaum K,Prager F,et al. Intraocular concentrations of growth factors and cytokines in retinal vein occlusion and the effect of therapy with bevacizumab. Invest Ophthalmol Vis Sci 2009;50(3):1025-1032
15 Coscas G,Augustin A,Bandello F,et al. Retreatment with Ozurdex for macular edema secondary to retinal vein occlusion. Eur J Ophthalmol 2014;24(1):1-9
16 Tservakis I,Koutsandrea C,Papaconstantinou D,et al. Safety and efficacy of dexamethasone intravitreal implant (Ozurdex) for the treatment of persistent macular edema secondary to retinal vein occlusion in eyes previously treated with anti-vascular endothelial growth factors. Curr Drug Saf 2015;10(2):145-151
17 Chen SD, Sundaram V, Lochhead J, et al. Intravitreal triamcinolone for the treatment of ischemic macular edema associated with branch retinal vein occlusion. Am J Ophthalmol 2006;141(5):876-883
18 Braithwaite T,Nanji AA,Greenberg PB. Anti-vascular endothelial growth factor for macular edema secondary to central retinal vein occlusion. Cochrane Database Syst Rev 2010;10:CD007325
19 Feng XX, Li C, Shao WW, et al. Intravitreal anti-VEGF agents, oral glucocorticoids, and laser photocoagulation combination therapy for macular edema secondary to retinal vein occlusion: preliminary report. Int J Ophthalmol 2018;11(3):429-437
20 Karagiannis DA, Karampelas MD, Soumplis VM, et al. Recurrence of macular edema in retinal vein occlusions after treatment with intravitreal ranibizumab (Lucentis). Can J Ophthalmol 2011;46(6):486-490
21 Miwa Y,Muraoka Y,Osaka R,et al. Ranibizumab for macular edema after branch retinal vein occlusion:One Initial Injection Versus Three Monthly Injections. Retina 2017;37(4):702-709
22 Ito Y, Saishin Y, Sawada O, et al. Comparison of single injection and three monthly injections of intravitreal bevacizumab for macular edema associated with branch retinal vein occlusion. Clin Ophthalmol 2015;9:175-180
23 Ahn SJ, Ahn J, Woo SJ, et al. Initial dose of three monthly intravitreal injections versus PRN intravitreal injections of bevacizumab for macular edema secondary to branch retinal vein occlusion. Biomed Res Int 2013;2013:209735
24蔡骐, 周跃, 黄黎黎, 等. 康柏西普治疗视网膜分支静脉阻塞继发黄斑水肿. 国际眼科杂志 2018;18(5):922-925
25 London NJ,Chiang A,Haller JA. The dexamethasone drug delivery system: indications and evidence. Adv Ther 2011;28(5):351-366