CAJ | 학술논문

目的：评估雷珠单抗玻璃体内注射（ IVR）与IVR联合格栅样光凝（ GLP）治疗视网膜分支静脉阻塞（BRVO）引起的黄斑水肿（ME）的近期疗效和安全性。方法28例（28只眼）继发于BRVO的ME患者，随机分成两组：一组单纯行雷珠单抗玻璃体内注射，一组于注射后2周行GLP。治疗后1、2、3、4、5、6个月随访视力和黄斑厚度，评估疗效。结果6个月后，与基线相比，IVR组平均最佳矫正视力（BCVA）提高（9．0±2．6）个ETDRS字母；IVR＋GLP组平均BCVA提高（12．3±3．2）个ETDRS字母，差异有统计学意义（ P分别为0．004，0．013）；IVR组黄斑厚度（CMT）减少（179．4±20．8）μm，IVR＋GLP组CMT减少（202．7±15．9）μm，差异有统计学意义（ P ＝0.0001）；两组间BCVA和CMT均无统计学差异（ P﹥0．05）；IVR组注射次数（3．2±1．1）明显高于IVR＋GLP组（1．9±1．0， P ＝0．002）；两组均未见严重副作用。结论 IVR和IVR＋GLP均能有效提高ME患者视力，减轻黄斑水肿，疗效无统计学差异；联合GLP治疗能减少雷珠单抗的注射次数，因而更经济、适用。
목적：평고뢰주단항파리체내주사（ IVR）여IVR연합격책양광응（ GLP）치료시망막분지정맥조새（BRVO）인기적황반수종（ME）적근기료효화안전성。방법28례（28지안）계발우BRVO적ME환자，수궤분성량조：일조단순행뢰주단항파리체내주사，일조우주사후2주행GLP。치료후1、2、3、4、5、6개월수방시력화황반후도，평고료효。결과6개월후，여기선상비，IVR조평균최가교정시력（BCVA）제고（9．0±2．6）개ETDRS자모；IVR＋GLP조평균BCVA제고（12．3±3．2）개ETDRS자모，차이유통계학의의（ P분별위0．004，0．013）；IVR조황반후도（CMT）감소（179．4±20．8）μm，IVR＋GLP조CMT감소（202．7±15．9）μm，차이유통계학의의（ P ＝0.0001）；량조간BCVA화CMT균무통계학차이（ P﹥0．05）；IVR조주사차수（3．2±1．1）명현고우IVR＋GLP조（1．9±1．0， P ＝0．002）；량조균미견엄중부작용。결론 IVR화IVR＋GLP균능유효제고ME환자시력，감경황반수종，료효무통계학차이；연합GLP치료능감소뢰주단항적주사차수，인이경경제、괄용。
Objective To compare the short-term efficacy and safety of intravitreal ranibizumab ( IVR) or IVR combined with grid laser photocogagulation ( GLP) for macular edema ( ME) secondary to branch retinal vein occlusion ( BRVO) .Methods 28 newly diagnosed patients with ME secondary to BRVO were divided into two groups randomly:one group was treated with IVR and the other group was treated with IVR and GLP.Patients were followed up at 1, 2, 3, 4, 5, 6 months, best corrected visual acuity (BCVA), changes in BCVA and central macular thickness (CMT) were com-pared in each phase and between groups.Results At month 6, BCVA change from baseline was 9.0 ±2.6 letters in the IVR group ( P =0.004) and 12.3 ±3.2 letters in the IVR+GLP group ( P =0.013).Mean CRT changes were 179.4 ±20.8 μm in the IVR group and 202.7 ±15.9 μm in the IVR+GLP group ( P =0.0001).There were nostatistically significant differences in BCVA or CRT changes between groups ( P﹥0.05).The number of intravitreal injections was significantly higher in the IVR group (3.2 ±1.1 injections) than in the IVR+GLP group (1.9 ±1.0 injections, P =0.002 ) .There were no serious side-effects in both groups.Conclusions IVR or IVR +GLP had similar effects on BCVA and CMT in patients with ME secondary to BRVO over a 6-month follow-up period.IVR+GLP is more affordable and toler-able for patients because of less intravitreal injections.