CAJ | 학술논문

目的观察玻璃体腔注射Avastin联合黄斑格栅样光凝治疗糖尿病黄斑水肿的效果.方法临床病例对照研究.对2010年5月至2011年5月在深圳市眼科医院就诊病人,将符合纳入标准并经眼底荧光造影(fundus fluorescein angiography,FFA)及相干光断层扫描(optical coherence tomography,OCT)确诊为糖尿病黄斑水肿(diabetic macular edema,DME)的患者45例59只眼,随机分为A、B二组,A组21例26只眼；B组24例33只眼.A组:单纯光凝组:接受单纯黄斑格栅样光凝；B组:联合治疗组:玻璃体腔注射Avastin 1.5 mg (0.06 ml),一周后给予黄斑格栅样光凝.所有患者治疗前及治疗后1、3、6个月均行视力、眼压、眼底检查和OCT检查.两组治疗前后对比行配对样本t检验统计分析,两组间采用单因素方差分析,P ＜0.05认为有统计学意义.结果组内比较:B组治疗后BCVA均优于治疗前,差异均有统计学意义；A组治疗后BCVA稍优于治疗前,差异无统计学意义.两组间治疗后CMT均优于治疗前,差异均有统计学意义.组间比较:治疗前:两组之间BCVA均无统计学意义(F =0.005,P＞0.05).治疗后:B组优于A组,两组间差异均有统计学意义(F =26.446,P ＜0.05).结论玻璃体腔注射Avastin联合黄斑格栅样光凝治疗糖尿病黄斑水肿疗效显著,可明显提高视力,消除或改善黄斑水肿.但尚需进一步大样本的临床随机对照研究来进一步证实.
목적 관찰파리체강주사Avastin연합황반격책양광응치료당뇨병황반수종적효과.방법 림상병례대조연구.대2010년5월지2011년5월재심수시안과의원취진병인,장부합납입표준병경안저형광조영(fundus fluorescein angiography,FFA)급상간광단층소묘(optical coherence tomography,OCT)학진위당뇨병황반수종(diabetic macular edema,DME)적환자45례59지안,수궤분위A、B이조,A조21례26지안；B조24례33지안.A조:단순광응조:접수단순황반격책양광응；B조:연합치료조:파리체강주사Avastin 1.5 mg (0.06 ml),일주후급여황반격책양광응.소유환자치료전급치료후1、3、6개월균행시력、안압、안저검사화OCT검사.량조치료전후대비행배대양본t검험통계분석,량조간채용단인소방차분석,P ＜0.05인위유통계학의의.결과 조내비교:B조치료후BCVA균우우치료전,차이균유통계학의의；A조치료후BCVA초우우치료전,차이무통계학의의.량조간치료후CMT균우우치료전,차이균유통계학의의.조간비교:치료전:량조지간BCVA균무통계학의의(F =0.005,P＞0.05).치료후:B조우우A조,량조간차이균유통계학의의(F =26.446,P ＜0.05).결론 파리체강주사Avastin연합황반격책양광응치료당뇨병황반수종료효현저,가명현제고시력,소제혹개선황반수종.단상수진일보대양본적림상수궤대조연구래진일보증실.
Objective To investigate the effects of intravitreal Avastin combined with macular grid photocoagulation (MGP) for diabetic macular edema (DME).Methods Fouty-five DME patients (59eyes) were divided into two groups randomly,26 eyes received MGP (MGP Group) and 33 eyes received intravitreal injection of 1.5 mg Avastin followed by MGP (combined Group).All eyes underwent a complete ophthalmic examination including BCVA,IOP,and OCT at baseline and 1,3,6months after treatment.The outcome measures were the changes compared with baseline in BCVA,changes in CMT.Dates were analyzed using the paired t-test and one-way ANOVA (SPSS 13.0).The BCVA levels were converted to logMAR equivalents and analyzed.P ＜ 0.05 was considered statistically significant.Results After treatment,the improvement in CMT in the MGP group was significant,yet there was no significant improvement in the mean BCVA (logMAR).The improvement in mean CMT was significant at 1,3,6 month (P ＜ 0.01),with corresponding improvement in the combined group.The BCVA did not deteriorate below baseline in all eyes included in the study,except two eyes in the MGP group.No complication related to the intravitreal injection occurred.Conclusions.Combination treatment with intravitreal Avastin and macular grid photocoagulation for DME is well tolerated,with a significantly improvement in BCVA and CMT.This suggests combination treatment with intravitreal Avastin and macular grid photocoagulation for diabetic merits further investigation.