CAJ | 학술논문

目的评估视网膜分支静脉阻塞(branch retinal vein occlusion,BRVO)继发黄斑水肿时浆液性视网膜神经上皮脱离(serous retinal detachment,SRD)与玻璃体腔注射Avastin疗效之间的关系.方法临床病例系列研究.回顾性分析2012年6月至2013年9月在北京大学眼科中心行玻璃体腔注射1.25mg (0.05ml) Avastin治疗BRVO继发黄斑水肿患者59例(59只眼).治疗前及治疗后1、3个月进行最佳矫正视力(BCVA)、眼压、裂隙灯、间接检眼镜检查和彩色眼底照相、光学相干断层扫描(OCT)检查;治疗前及治疗后3月行荧光素眼底血管造影(FFA)检查.根据OCT图像有无SRD,将患者分为SRD(+)组与SRD(-)组.结果 SRD(+)组22例(37.29％,22/59)患者,平均年龄低于SRD(-)组差异有统计学意义(P＜0.05),术前黄斑中心区厚度(central subfield macularthickness,CSMT)明显＞SRD(-)组差异有统计学意义(P＜0.01).玻璃体腔注射Avastin后1、3个月,SRD(+)组CSMT的改善幅度明显＞SRD(-)组差异有统计学意义(P＜0.01);玻璃体腔注射Avastin后3个月,SRD(+)组BCVA的提高幅度亦大于SRD(-)组差异有统计学意义(P＜0.05).结论玻璃体腔注射Avastin治疗BRVO继发黄斑水肿合并SRD的患者CSMT及BCVA改善幅度更大,效果明显.
목적 평고시망막분지정맥조새(branch retinal vein occlusion,BRVO)계발황반수종시장액성시망막신경상피탈리(serous retinal detachment,SRD)여파리체강주사Avastin료효지간적관계.방법 림상병례계렬연구.회고성분석2012년6월지2013년9월재북경대학안과중심행파리체강주사1.25mg (0.05ml) Avastin치료BRVO계발황반수종환자59례(59지안).치료전급치료후1、3개월진행최가교정시력(BCVA)、안압、렬극등、간접검안경검사화채색안저조상、광학상간단층소묘(OCT)검사;치료전급치료후3월행형광소안저혈관조영(FFA)검사.근거OCT도상유무SRD,장환자분위SRD(+)조여SRD(-)조.결과 SRD(+)조22례(37.29％,22/59)환자,평균년령저우SRD(-)조차이유통계학의의(P＜0.05),술전황반중심구후도(central subfield macularthickness,CSMT)명현＞SRD(-)조차이유통계학의의(P＜0.01).파리체강주사Avastin후1、3개월,SRD(+)조CSMT적개선폭도명현＞SRD(-)조차이유통계학의의(P＜0.01);파리체강주사Avastin후3개월,SRD(+)조BCVA적제고폭도역대우SRD(-)조차이유통계학의의(P＜0.05).결론 파리체강주사Avastin치료BRVO계발황반수종합병SRD적환자CSMT급BCVA개선폭도경대,효과명현.
Objective To evaluate the relationship of serous retinal detachment (SRD) and treatment outcome after intravitreal Avastin injection in patients with macular edema due to branch retinal vein occlusion (BRVO).Methods A retrospective case-observation study.The clinical data of 59 patients (59 eyes) from with macular edema secondary to BRVO who received intravitreal Avastin injection (1.25mg/0.05mL) were included in this study.All the patients did not receive other any therapy prior to the injection of Avastin.Clinical indexes included best corrected visual acuity (BC-VA),intraocular pressure,slit-lamp examination,stereoscopic biomicroscopy examination and fundus photography,optical coherence tomography (OCT) before injection and 1 month,3 months after initial injection.Fluorescein fundus angiography (FFA) was performed prior to injection and 3 months after initial injection.Patients were separated into 2 groups:SRD (+) and SRD (-),according to the presence or absence of SRD on OCT.Results SRD was found in 22 patients (37.29％).The age was younger in the SRD (+) group than in the SRD (-) group (P ＜0.05).The baseline central subfield macular thickness (CSMT) was significantly thicker in the SRD (+) group than in the SRD (-) group (P ＜0.001).One month and 3 months after initial intravitreal injection of Avastin,greater reductions in CSMT change from baseline were observed in the SRD (+) group than in the SRD (-) group (P ＜0.001).Three months after the initial injection,a grater improvement of BCVA was also found in the SRD (+) group than in the SRD (-) group (P ＜0.05).Conclusions Patients with SRD has greater reductions in CSMT and improvements of BCVA after intravitreal Avastin injection in patients with macular edema due to BRVO.