中华眼底病杂志
中華眼底病雜誌
중화안저병잡지
CHINESE JOURNAL OF OCULAR FUNDUS DISEASES
2015年
1期
18-21
,共4页
视网膜静脉闭塞/治疗%血管生成抑制剂/治疗应用%抗体,单克隆/治疗应用%激光凝固术
視網膜靜脈閉塞/治療%血管生成抑製劑/治療應用%抗體,單剋隆/治療應用%激光凝固術
시망막정맥폐새/치료%혈관생성억제제/치료응용%항체,단극륭/치료응용%격광응고술
Retinal vein occlusion/therapy%Angiogenesis inhibitors/therapeutic use%Antibodies,monoclonal/therapeutic use%Laser coagulation
目的 观察玻璃体腔注射雷珠单抗(IVR)联合曲安奈德(TA)或激光光凝治疗视网膜分支静脉阻塞(BRVO)继发黄斑水肿的安全性及有效性.方法 回顾性研究.临床确诊为BRVO继发黄斑水肿的31例患者31只眼纳入研究.所有患者均行最佳矫正视力(BCVA)、荧光素眼底血管造影(FFA)及光相干断层扫描(OCT)检查.视力检查采用标准对数视力表进行,并将结果转换为最小分辨角对数(logMAR)视力记录.患眼平均logMAR BCVA为(0.74±0.36),平均中央视网膜厚度(CRT)为(484.48±164.81) μm.所有患者均行常规玻璃体腔注射10 mg/ml的雷珠单抗0.05 ml(含雷珠单抗0.5 mg).出现黄斑水肿时,按需进行IVR治疗;第3次IVR治疗时黄斑水肿消退不明显者同时联合TA注射治疗.OCT检查发现黄斑水肿明显消退时,给予黄斑激光光凝治疗;FFA检查发现周边视网膜出现无灌注区,行周边视网膜激光光凝治疗.患眼接受雷珠单抗平均注射次数为(3.52±2.01)次;联合注射TA治疗15只眼,平均注射次数为(0.84±1.21)次;联合激光光凝治疗21只眼,平均次数为(0.97±0.95)次.先后接受了IVR联合TA和激光光凝这3种治疗12只眼.所有患者均随访1年.对比分析患眼治疗前后logMAR BCVA及CRT的变化情况.结果 患眼平均logMAR BCVA为(0.42±0.33).治疗前后logMAR BCVA比较,差异有统计学意义(t=6.611,P=0.000).治疗后视力较治疗前平均提高了(2.90±3.07)行.31只眼中,视力提高3行及以上者20只眼,占64.52％.患眼平均CRT为(326.19±117.80) μm.治疗后CRT较治疗前平均降低了(333.58±134.17) μm.治疗前后CRT比较,差异有统计学意义(t=4.514,P=0.000).31只眼中,CRT降低在100μm以上者17只眼,占54.84％.随访期间所有患眼均未发生白内障加重、眼内炎、视网膜脱离等严重并发症.结论 IVR联合TA或激光光凝治疗BRVO继发黄斑水肿有良好的疗效及安全性,可以明显提高患者视力并减轻黄斑水肿.
目的 觀察玻璃體腔註射雷珠單抗(IVR)聯閤麯安奈德(TA)或激光光凝治療視網膜分支靜脈阻塞(BRVO)繼髮黃斑水腫的安全性及有效性.方法 迴顧性研究.臨床確診為BRVO繼髮黃斑水腫的31例患者31隻眼納入研究.所有患者均行最佳矯正視力(BCVA)、熒光素眼底血管造影(FFA)及光相榦斷層掃描(OCT)檢查.視力檢查採用標準對數視力錶進行,併將結果轉換為最小分辨角對數(logMAR)視力記錄.患眼平均logMAR BCVA為(0.74±0.36),平均中央視網膜厚度(CRT)為(484.48±164.81) μm.所有患者均行常規玻璃體腔註射10 mg/ml的雷珠單抗0.05 ml(含雷珠單抗0.5 mg).齣現黃斑水腫時,按需進行IVR治療;第3次IVR治療時黃斑水腫消退不明顯者同時聯閤TA註射治療.OCT檢查髮現黃斑水腫明顯消退時,給予黃斑激光光凝治療;FFA檢查髮現週邊視網膜齣現無灌註區,行週邊視網膜激光光凝治療.患眼接受雷珠單抗平均註射次數為(3.52±2.01)次;聯閤註射TA治療15隻眼,平均註射次數為(0.84±1.21)次;聯閤激光光凝治療21隻眼,平均次數為(0.97±0.95)次.先後接受瞭IVR聯閤TA和激光光凝這3種治療12隻眼.所有患者均隨訪1年.對比分析患眼治療前後logMAR BCVA及CRT的變化情況.結果 患眼平均logMAR BCVA為(0.42±0.33).治療前後logMAR BCVA比較,差異有統計學意義(t=6.611,P=0.000).治療後視力較治療前平均提高瞭(2.90±3.07)行.31隻眼中,視力提高3行及以上者20隻眼,佔64.52％.患眼平均CRT為(326.19±117.80) μm.治療後CRT較治療前平均降低瞭(333.58±134.17) μm.治療前後CRT比較,差異有統計學意義(t=4.514,P=0.000).31隻眼中,CRT降低在100μm以上者17隻眼,佔54.84％.隨訪期間所有患眼均未髮生白內障加重、眼內炎、視網膜脫離等嚴重併髮癥.結論 IVR聯閤TA或激光光凝治療BRVO繼髮黃斑水腫有良好的療效及安全性,可以明顯提高患者視力併減輕黃斑水腫.
목적 관찰파리체강주사뢰주단항(IVR)연합곡안내덕(TA)혹격광광응치료시망막분지정맥조새(BRVO)계발황반수종적안전성급유효성.방법 회고성연구.림상학진위BRVO계발황반수종적31례환자31지안납입연구.소유환자균행최가교정시력(BCVA)、형광소안저혈관조영(FFA)급광상간단층소묘(OCT)검사.시력검사채용표준대수시력표진행,병장결과전환위최소분변각대수(logMAR)시력기록.환안평균logMAR BCVA위(0.74±0.36),평균중앙시망막후도(CRT)위(484.48±164.81) μm.소유환자균행상규파리체강주사10 mg/ml적뢰주단항0.05 ml(함뢰주단항0.5 mg).출현황반수종시,안수진행IVR치료;제3차IVR치료시황반수종소퇴불명현자동시연합TA주사치료.OCT검사발현황반수종명현소퇴시,급여황반격광광응치료;FFA검사발현주변시망막출현무관주구,행주변시망막격광광응치료.환안접수뢰주단항평균주사차수위(3.52±2.01)차;연합주사TA치료15지안,평균주사차수위(0.84±1.21)차;연합격광광응치료21지안,평균차수위(0.97±0.95)차.선후접수료IVR연합TA화격광광응저3충치료12지안.소유환자균수방1년.대비분석환안치료전후logMAR BCVA급CRT적변화정황.결과 환안평균logMAR BCVA위(0.42±0.33).치료전후logMAR BCVA비교,차이유통계학의의(t=6.611,P=0.000).치료후시력교치료전평균제고료(2.90±3.07)행.31지안중,시력제고3행급이상자20지안,점64.52％.환안평균CRT위(326.19±117.80) μm.치료후CRT교치료전평균강저료(333.58±134.17) μm.치료전후CRT비교,차이유통계학의의(t=4.514,P=0.000).31지안중,CRT강저재100μm이상자17지안,점54.84％.수방기간소유환안균미발생백내장가중、안내염、시망막탈리등엄중병발증.결론 IVR연합TA혹격광광응치료BRVO계발황반수종유량호적료효급안전성,가이명현제고환자시력병감경황반수종.
Objective To investigate the efficacy and safety of intravitreal ranibizumab and (or) triamcinolone combined with laser photocoagulation for macular edema secondary to branch retinal vein occlusion (BRVO) during one year period.Methods The data of 31 eyes from 31 consecutive patients with macular edema secondary to BRVO during one year follow-up visit were retrospectively analyzed.Mean best corrected visual acuity (BCVA) logMAR was (0.74±0.36) and mean central retinal thickness (CRT) was (484.48± 164.81) μm at baseline.All patients received standardized clinical comprehensive examinations including vision,intraocular pressure and optical coherence tomography for diagnosis before treatment.All patients received intravitreal injections of 0.5 mg ranibizumab (0.05 ml) at first visit.The continue PRN treatment were based on the visual acuity changes and the optical coherence tomography findings.Eyes received combined triamcinolone acetonide 0.05 ml (40 mg/ml) and ranibizumab for macular edema recurrence after two injections of ranibizumab and received laser photocoagulation during 10-14 days after third injections of ranibizumab.Mean injection of ranibizumab was 3.52± 2.01,15 eyes with triamcinolone acetonide (0.84 ± 1.21),21 eyes with laser photocoagulation (0.97± 0.95) and 12 eyes with three treatment.Compared the visual acuities and CRTs of the first and the last visits by statistical analysis.Results Mean visual acuity improved significantly to 0.42±0.33 logMAR (t=6.611,P=0.000).Mean improvement of visual acuity was 2.90± 3.07 lines.A gain of three or more logarithmic lines was evaluated in 20/31 eyes (64.52％) at the last visit.Mean CRT was (326.19± 117.80) μm (t=4.514,P=0.000).Mean reduction of CRT was (333.58±134.17) μm.A decrease of 100 μm of CRT was evaluated in 17/31 eyes (54.84％).No severe ocular and systematic side effect was found.Conclusion The efficacy and safety of intravitreal ranibizumab and (or) triamcinolone combined with laser photocoagulation for macular edema secondary to BRVO were assured.
