CAJ | 학술논문

目的观察高海拔地区玻璃体腔内注射雷珠单抗注射液治疗脉络膜新生血管(CNV)的临床疗效.方法对2013年5月至2014年3月在青海省人民医院眼科经视力、眼压、眼底检查、眼底彩色照相、荧光素眼底血管造影(FFA)、光相干断层扫描(OCT)检查确诊为脉络膜新生血管的患者17例17只眼纳入治疗.患者中男13例13只眼,女4例4只眼.年龄41～80岁,平均(56±12.58)岁,病程0.3～12个月,矫正视力0.01～1.0,平均眼压(15.94±2.51) mmHg.入选病例全部CNV在距黄斑中心凹500 μm范围内.在表面麻醉下给予0.5 mg雷珠单抗注射液玻璃体腔内注射.治疗后1、6个月随访.结果末次随访时,矫正视力0.01～1.2,与治疗前平均视力比较,差异有统计学意义(t值2.512,P＜0.05).其中视力提高4行以上者4只眼,占23.53％ (4/17);提高2～4行者6只眼,占35.29％ (6/17);稳定或波动在1行以内者3只眼,占17.65％ (3/17);较前无改善者4只眼,占23.53％ (4/17).治疗后平均眼压(16.24±2.02) mmHg,与治疗前平均眼压比较,差异无统计学意义(t值0.792,P＞0.05).眼底血管造影检查结果显示,CNV完全闭合者13例,占76.47％;4例CNV部分闭合,轻微荧光渗漏,占23.53％;OCT检查示CNV强反射区域缩小,视网膜下积液吸收,黄斑区视网膜厚度下降.结论高海拔地区玻璃体腔注射雷珠单抗注射液治疗脉络膜新生血管视力提高较明显,促使脉络膜CNV渗漏停止或减轻,促使视网膜水肿消退或减轻,疗效好,安全可靠.
목적 관찰고해발지구파리체강내주사뢰주단항주사액치료맥락막신생혈관(CNV)적림상료효.방법 대2013년5월지2014년3월재청해성인민의원안과경시력、안압、안저검사、안저채색조상、형광소안저혈관조영(FFA)、광상간단층소묘(OCT)검사학진위맥락막신생혈관적환자17례17지안납입치료.환자중남13례13지안,녀4례4지안.년령41～80세,평균(56±12.58)세,병정0.3～12개월,교정시력0.01～1.0,평균안압(15.94±2.51) mmHg.입선병례전부CNV재거황반중심요500 μm범위내.재표면마취하급여0.5 mg뢰주단항주사액파리체강내주사.치료후1、6개월수방.결과 말차수방시,교정시력0.01～1.2,여치료전평균시력비교,차이유통계학의의(t치2.512,P＜0.05).기중시력제고4행이상자4지안,점23.53％ (4/17);제고2～4행자6지안,점35.29％ (6/17);은정혹파동재1행이내자3지안,점17.65％ (3/17);교전무개선자4지안,점23.53％ (4/17).치료후평균안압(16.24±2.02) mmHg,여치료전평균안압비교,차이무통계학의의(t치0.792,P＞0.05).안저혈관조영검사결과현시,CNV완전폐합자13례,점76.47％;4례CNV부분폐합,경미형광삼루,점23.53％;OCT검사시CNV강반사구역축소,시망막하적액흡수,황반구시망막후도하강.결론 고해발지구파리체강주사뢰주단항주사액치료맥락막신생혈관시력제고교명현,촉사맥락막CNV삼루정지혹감경,촉사시망막수종소퇴혹감경,료효호,안전가고.
Objective To observe the clinical curative effect by injecting Lucentis to vitreous treating choroid neovascularization (CNV) at high altitude.Methods Through visual acuity,intraocular pressure,fundus examination,fundus color photography,fluorescence fundus angiography (FFA) and optical coherence tomography (OCT) inspection diagnosed of choroid neovascularization,17 cases (17 eyes) in patients with the treatment.In patients with male 13 cases of 13 eyes,female 4 cases 4 eyes.Aged 41 to 80,average (56±12.58),0.3-12 months duration,vision correction 0.01-1.0,the average intraocular pressure (15.94±2.51) mmHg (1 mmHg=0.133 kPa).All cases of CNV in the 500 μm range from the center fovea of macula.Under surface anesthesia 0.5mg lucentis was injected into vitreous,1,6 months followed-up after treatment.Results At the time of last followed-up,the corrected visual acuity 0.01-1.2,compared with average eyesight before treatment,it was statistically significant (t =2.512,P ＜0.01).Four eyes vision improve 4 lines,accounted for 23.53％ (4/17);6 eyes vision improve 2-4 lines,accounted for 35.29％ (6/17); 3 eyes stable or fluctuations within 1 row,accounted for 17.65％ (3/17); 4 eyes no improvement,accounted for 23.53％ (4/17).Average intraocular pressure (16.24±2.02) mmHg after treatment,it was no statistically significant difference (t =0.792,P ＞0.05).According to the results of fundus angiography,14 cases of CNV closed completely,accounted for 77.78％,4 cases of CNV partly closed,fluorescence slight leakaged,accounted for 22.22％; OCT examination revealed CNV strong reflection area shrinking,subretinal effusion absorption,the macular area retinal thickness decrease.Conclusions It is apparent to improve vision by injecting Lucentis to vitreous treating choroid neovascularization (CNV) at high altitude,which can prompt choroid CNV stop or reduce leakage,prompt retinal edema fade or ease,it is good curative effect,safe and reliable.