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
22-26
,共5页
张菁%蔡小军%陈晓敏%郑恬%郭别川%韩芳芳%王越%柯敏
張菁%蔡小軍%陳曉敏%鄭恬%郭彆川%韓芳芳%王越%柯敏
장정%채소군%진효민%정념%곽별천%한방방%왕월%가민
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 观察玻璃体腔注射康柏西普联合视网膜激光光凝治疗视网膜分支静脉阻塞(BRVO)继发黄斑水肿的疗效.方法 临床检查确诊的BRVO继发黄斑水肿患者38例38只眼纳入研究.所有患者均行最佳矫正视力(BCVA)、裂隙灯显微镜联合78D前置镜、眼压、光相干断层扫描、荧光素服底血管造影检查.依据就诊顺序按照随机排列表方法随机将患者分为康柏西普+激光组(CL组)、曲安奈德(TA)+激光组(TL组)、激光组(L组),分别为14、13、11只眼.CL组、TL组玻璃体腔分别注入雷珠单抗0.05 ml(含康柏西普0.5 mg)和TA 0.10 ml(含TA 4.0 mg);L组行单纯视网膜激光光凝治疗.3组间BCVA(F=0.003)、黄斑中心视网膜厚度(CMT) (F=0.002)比较,差异无统计学意义(P＞0.05).对比观察3组间治疗后1d,1周,1、3个月患眼BCVA和(CMT)的变化情况.同时观察与药物和治疗方式相关的眼部和全身不良反应发生情况.结果 治疗后1d,1周,1、3个月,3组间BCVA提高、稳定、下降眼数(x2=9.754、12.430、17.424、13.189)比较,差异均有统计学意义(P＜0.05).组间两两比较,CL组BCVA提高及稳定眼数明显多于L组,差异均有统计学意义(x2=9.339、11.414、14.528、10.319,P＜0.01);与TL组比较,差异无统计学意义(x2=1.439、1.060、0.479、0.016,P＞0.05).3组间不同观察时间点平均CMT(F=10.614、4.099、4.927、8.99)比较,差异均有统计学意义(P＜0.05).CL组治疗后不同观察时间点平均CMT均较L组降低,差异有统计学意义(t=3.967、2.836、2.095、4.223,P＜0.05);CL组与TL组比较,治疗后3个月时,差异有统计学意义(t=2.128,P＜0.05);1 d,1周,1个月时,差异均无统计学意义(t=0.075、0.020、0.079,P＞0.05).CL组未见与药物、玻璃体腔注射相关的眼部和全身不良反应发生.TL组眼压升高1只眼,局部应用降眼压药物后,眼压恢复正常.结论 玻璃体腔注射康柏西普联合视网膜激光光凝疗效优于单纯激光光凝;治疗后3个月较玻璃体腔注射TA联合激光光凝治疗能保持更强的促进水肿吸收的作用.
目的 觀察玻璃體腔註射康柏西普聯閤視網膜激光光凝治療視網膜分支靜脈阻塞(BRVO)繼髮黃斑水腫的療效.方法 臨床檢查確診的BRVO繼髮黃斑水腫患者38例38隻眼納入研究.所有患者均行最佳矯正視力(BCVA)、裂隙燈顯微鏡聯閤78D前置鏡、眼壓、光相榦斷層掃描、熒光素服底血管造影檢查.依據就診順序按照隨機排列錶方法隨機將患者分為康柏西普+激光組(CL組)、麯安奈德(TA)+激光組(TL組)、激光組(L組),分彆為14、13、11隻眼.CL組、TL組玻璃體腔分彆註入雷珠單抗0.05 ml(含康柏西普0.5 mg)和TA 0.10 ml(含TA 4.0 mg);L組行單純視網膜激光光凝治療.3組間BCVA(F=0.003)、黃斑中心視網膜厚度(CMT) (F=0.002)比較,差異無統計學意義(P＞0.05).對比觀察3組間治療後1d,1週,1、3箇月患眼BCVA和(CMT)的變化情況.同時觀察與藥物和治療方式相關的眼部和全身不良反應髮生情況.結果 治療後1d,1週,1、3箇月,3組間BCVA提高、穩定、下降眼數(x2=9.754、12.430、17.424、13.189)比較,差異均有統計學意義(P＜0.05).組間兩兩比較,CL組BCVA提高及穩定眼數明顯多于L組,差異均有統計學意義(x2=9.339、11.414、14.528、10.319,P＜0.01);與TL組比較,差異無統計學意義(x2=1.439、1.060、0.479、0.016,P＞0.05).3組間不同觀察時間點平均CMT(F=10.614、4.099、4.927、8.99)比較,差異均有統計學意義(P＜0.05).CL組治療後不同觀察時間點平均CMT均較L組降低,差異有統計學意義(t=3.967、2.836、2.095、4.223,P＜0.05);CL組與TL組比較,治療後3箇月時,差異有統計學意義(t=2.128,P＜0.05);1 d,1週,1箇月時,差異均無統計學意義(t=0.075、0.020、0.079,P＞0.05).CL組未見與藥物、玻璃體腔註射相關的眼部和全身不良反應髮生.TL組眼壓升高1隻眼,跼部應用降眼壓藥物後,眼壓恢複正常.結論 玻璃體腔註射康柏西普聯閤視網膜激光光凝療效優于單純激光光凝;治療後3箇月較玻璃體腔註射TA聯閤激光光凝治療能保持更彊的促進水腫吸收的作用.
목적 관찰파리체강주사강백서보연합시망막격광광응치료시망막분지정맥조새(BRVO)계발황반수종적료효.방법 림상검사학진적BRVO계발황반수종환자38례38지안납입연구.소유환자균행최가교정시력(BCVA)、렬극등현미경연합78D전치경、안압、광상간단층소묘、형광소복저혈관조영검사.의거취진순서안조수궤배렬표방법수궤장환자분위강백서보+격광조(CL조)、곡안내덕(TA)+격광조(TL조)、격광조(L조),분별위14、13、11지안.CL조、TL조파리체강분별주입뢰주단항0.05 ml(함강백서보0.5 mg)화TA 0.10 ml(함TA 4.0 mg);L조행단순시망막격광광응치료.3조간BCVA(F=0.003)、황반중심시망막후도(CMT) (F=0.002)비교,차이무통계학의의(P＞0.05).대비관찰3조간치료후1d,1주,1、3개월환안BCVA화(CMT)적변화정황.동시관찰여약물화치료방식상관적안부화전신불량반응발생정황.결과 치료후1d,1주,1、3개월,3조간BCVA제고、은정、하강안수(x2=9.754、12.430、17.424、13.189)비교,차이균유통계학의의(P＜0.05).조간량량비교,CL조BCVA제고급은정안수명현다우L조,차이균유통계학의의(x2=9.339、11.414、14.528、10.319,P＜0.01);여TL조비교,차이무통계학의의(x2=1.439、1.060、0.479、0.016,P＞0.05).3조간불동관찰시간점평균CMT(F=10.614、4.099、4.927、8.99)비교,차이균유통계학의의(P＜0.05).CL조치료후불동관찰시간점평균CMT균교L조강저,차이유통계학의의(t=3.967、2.836、2.095、4.223,P＜0.05);CL조여TL조비교,치료후3개월시,차이유통계학의의(t=2.128,P＜0.05);1 d,1주,1개월시,차이균무통계학의의(t=0.075、0.020、0.079,P＞0.05).CL조미견여약물、파리체강주사상관적안부화전신불량반응발생.TL조안압승고1지안,국부응용강안압약물후,안압회복정상.결론 파리체강주사강백서보연합시망막격광광응료효우우단순격광광응;치료후3개월교파리체강주사TA연합격광광응치료능보지경강적촉진수종흡수적작용.
Objective To investigate the effects and safety of intravitreous injection of Conbercept combined with laser photocoagulation for macular edema secondary to branch retinal vein occlusion.Methods All subjects were assigned randomly to 3 groups:intravitreal Conbercept combined with laser photocoagulation group (CL group),intravitreal triamcinolone combined with laser photocoagulation group (TL group),and photocoagulation group (L group).The best-corrected visual acuity (BCVA),central macular thickness (CMT),fundus oculi and fundus fluorescein angiography (FFA),intraocular pressure (IOP),slit lamp were observed before and 1 day,1 week,1 month,3 months after treatment.The changes of post-treatment BCVA and CMT in pre-therapy and post-treatment were compared,and related complications were recorded.Results There were significant differences of BCVA (x2 =9.754,12.430,17.424,13.189) and CMT (F=10.614,4.099,4.927,8.99) between 3 groups in post-treatment 1 day,1 week,1 month and 3 months.The numbers of subjects of improving and stabilizing BCVA in CL group were remarkably more than that in L group in every post-treatment follow-up time (P＜0.01),whereas the CMTs in CL group were significantly less than that in L group in every post treatment follow up time (P＜ 0.05).The CMTs in post-treatment 1 day,1 week,1 month,3 months were thinner than that in pretreatment in CL group and TL group (P＜0.05).Meanwhile,there was no significant difference (P＞ 0.05) between any two CMTs in post-treatment 1 day,1 week,1 month and 3 months in CL group.Yet,the CMT in post-treatment 3 months was thicker than those in post-treatment 1 day,1 week and 1 month in TL group (P＜ 0.05).And there was no significant difference (P＞ 0.05) between any two CMTs in post-treatment 1 day,1 week and 1 month in TL group.There was no conspicuous difference in CMTs(P＞ 0.05) between in CL group and in TL group in every viewing time,except for that in post treatment 3 months(P＜0.05).There was only 1 case of intraocular hypertension in post-treatment in TL group.Conclusions Intravitreous injection of Conbercept combined with laser photocoagulation for macular edema secondary to BRVO is effective,safe,and superior to laser photocoagulation only.Also it had a longer effective duration and less complications than intravitreal triamcinolone combined with laser photocoagulation.
