雷珠单抗联合微脉冲激光治疗视网膜分支静脉阻塞继发黄斑水肿的疗效观察

doi:10.3969/j.issn.1671-7171.2020.08.011

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摘要【目的】观察雷珠单抗联合532 nm阈下微脉冲激光治疗视网膜分支静脉阻塞(BRVO)继发黄斑水肿(ME)的临床疗效。【方法】将30例(30眼)BRVO继发ME患者按照随机数表法分为观察组和对照组。对照组采用雷珠单抗治疗,观察组在对照组基础上加用532 nm阈下微脉冲激光治疗。比较两组治疗前、后最佳矫正视力(BCVA)、黄斑中心凹视网膜厚度(CMT)、重复注射次数、并发症等。【结果】两组患者治疗后BCVA依次降低,与治疗前相比差异有统计学意义(P<0.05);但两组各时间点BCVA比较差异无统计学意义(P>0.05)。两组CMT治疗后逐步降低,与治疗前相比差异有统计学意义(P<0.05);观察组组内除治疗后d₇与1个月比较差异无统计学意义(t=0.954,P>0.05)外,余各时间点对比差异均有统计学意义(P<0.05);观察组平均眼内注药(1.73±0.96)次,显著低于对照组的(3.07±0.70)次,其差异有统计学意义(P<0.05)。随访期间均未发生眼部及全身严重不良反应。【结论】玻璃体腔注射雷珠单抗联合532 nm阈下微脉冲激光治疗BRVO继发ME可改善黄斑水肿、提高视力,减少眼内注药次数,值得临床推广应用。

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关键词 ：视网膜静脉闭塞/治疗, 黄斑水肿/治疗, 激光疗法

Abstract：【Objective】 To investigate the clinical efficacy of intravitreal injection ranibizumab combined with 532nm subthreshold micropulse laser photocoagulation treatment for macular edema (ME) secondary to branch retinal vein occlusion (BRVO). 【Methods】 A total of 30 patients (30 eyes) with macular edema secondary to branch retinal vein occlusion were randomly divided into the control group (with ranibizumab therapy) and the observation group (ranibizumab combined with 532nm subthreshold micropulse laser therapy).The best corrected visual acuity(BCVA),central macular thickness(CMT), repeated injection times and complications were compared between the two groups before and after treatment. 【Results】 After treatment, patients' BCVA of the two groups decreased; And the difference was statistically significant compared to that before treatment (P<0.05). However, there was no statistically significant difference in BCVA between the two groups at each time point (P>0.05). The CMT of the two groups gradually decreased after treatment, and the difference was statistically significant compared with that before treatment (P<0.05). There was no significant difference within the observation group only at d7 and 1 month after treatment (t=0.954,P>0.05); The differences at the remaining time points within the observation group showed statistically significant (P<0.05). Patients in the observation group had an average intraocular injection (1.73±0.96) times, which was significantly lower than the control group (3.07±0.70) times. The difference was statistically significant (P<0.05). No serious eye and systemic adverse reactions occurred during follow-up. 【Conclusion】 Intravitreal injection ranibizumab combined with 532nm subthreshold micropulse laser photocoagulation shows effective treatment for macular edema secondary to branch retinal vein occlusion, which can improve condition of macular edema and vision. It also reduces the number of intraocular injection.

Key words： Retinal Vein Occlusion/TH Macular Edema/TH Laser Therapy

收稿日期: 2019-11-28

PACS:

R774.5

基金资助:清远市科技技术开发类 (NO. 2018B052)

引用本文:

曾凤, 卢亚梅, 周元清, 陈永铃, 杨婷婷. 雷珠单抗联合微脉冲激光治疗视网膜分支静脉阻塞继发黄斑水肿的疗效观察[J]. 医学临床研究, 2020, 37(8): 1154-1157.
ZENG Feng, LU Ya-mei, ZHOU Yuan-qing, et al. Efficacy of Intravitreal Injection Ranibizumab Combined with Subthreshold Micropulse Laser Photocoagulation Treatment for Macular Edema Secondary to Branch Retinal Vein Occlusion. JOURNAL OF CLINICAL RESEARCH, 2020, 37(8): 1154-1157.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2020.08.011 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2020/V37/I8/1154

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