玻璃体腔注射雷珠单抗联合视网膜激光光凝术治疗视网膜分支静脉阻塞继发黄斑水肿的效果观察

目的 目的对视网膜分支静脉阻塞继发黄斑水肿采用玻璃体腔注射雷珠单抗联合视网膜激光光凝术治疗的有效性进行对比和观察.方法 选择我院确诊的90例(90眼)符合入组标准的视网膜分支静脉阻塞继发性黄斑水肿的患者作为研究对象,按随机数字表分为Ⅰ组、Ⅱ组、Ⅲ组,每组各30例(30眼),Ⅰ组患者单纯予以玻璃体腔注射雷珠单抗0.05ml/0.5mg治疗,Ⅱ组患者单纯予以黄斑区格栅样光凝术治疗,Ⅲ组先予以玻璃体腔注射雷珠单抗治疗,1周后再予以视网膜激光光凝术治疗,治疗前、治疗后3、6个月采用LogMAR视力表检查最佳矫正视力(BCVA),采用光学相关断层扫描(OCT)检查黄斑中心凹厚度(CMT),评价临床疗效.结果 Ⅰ组、Ⅱ组、Ⅲ组治疗后3、6个月的BCVA均较治疗前明显升高(均P＜0.05),Ⅰ组、Ⅱ组、Ⅲ组治疗后3、6个月BCVA差异具有统计学意义(P＜0.05),Ⅰ组、Ⅱ组治疗后3、6个月的BCVA升高值均明显小于Ⅲ组(P＜0.05).Ⅰ组、Ⅱ组、Ⅲ组治疗后3、6个月的CMT均较治疗前降低(均P＜0.05),Ⅰ组、Ⅱ组、Ⅲ组治疗后3、6个月的CMT差异具有统计学意义(P＜0.05),Ⅰ组、Ⅱ组治疗后3、6个月CMT降低值明显小于Ⅲ组(P＜0.05).Ⅲ组治疗3、6个月的临床疗效效果高于Ⅰ组、Ⅱ组(P＜0.05).结论 玻璃体腔注射雷珠单抗联合视网膜激光光凝术治疗视网膜分支静脉阻塞继发黄斑水肿的效果优于单纯注药或者单纯光凝的效果,对视力改善及促进黄斑水肿吸收的效果更快、更好.

Treatment of macular edema secondary to retinal veinocclusion with introvirtreal ranibizumab combined with retinal photocoagulation

Objective To investigate the clinical effect of introvitrealranibizumab combined with retinal photocoagulation for the treatment of macular edema secondary to retinal vein occlusion.Methods Ninety eyes (90 patients) diagnosed with retinal vein occlusion in our hospital were included into this study,and were randomly assigned into 3 groups.Grouplreceived intravitreal ranibizumab 0.05ml/0.5mg;group Ⅱwere treated with macular grid photocoagulation;and group Ⅲ were treated with intra-vitrealranibizumab0.05ml/0.5mg combined with macular grid photocoagulation 1 week later.Best corrected visual acuity (BCVA) were measured using LogMAR,3 months and 6months postoperatively,central macular thickness (CMT) were recorded using optical coherence tomography(OCT).Results All groups had better BCVA 3 months and 6 months postoperatively than preoperative.BCVA and the differences were statistically significant (P＜0.05);BCVA improvement of group Ⅲ was significant than that of group Ⅰ and group Ⅱ (P＜0.05).All groups have decreased CMT 3 months and 6 months postoperatively than preoperative CMT and the differences were statistically significant (P＜0.05);CMT improvement of group Ⅲ was better than that of group Ⅰ and group Ⅱ (P＜0.05);group Ⅲ had better clinical effect than that of group Ⅱ and group Ⅰ.Conclusion Better clinical effect such as BCVA and CMT improvement with the treatment of macular edema secondary to retinal vein occlusion can be obtained using introvitreal ranibizumab combined with retinal photocoagulation when compared with introvitreal ranibizumab or retinal photocoagulation alone.