视网膜光凝联合雷珠单抗玻璃体内注射治疗视网膜中央静脉阻塞

Clinical observation on intravitreous injection of Lucentis combined with argon laser photocoagulation for treatment of ischemic central retinal vein occlusion

目的:研究氩激光视网膜光凝联合雷珠单抗玻璃体内注射治疗缺血型视网膜中央静脉阻塞(central retinal vein occlusion,CRVO)伴发黄斑水肿及视网膜新生血管的临床疗效。方法:回顾性分析2012-01/2013-05就诊于我院眼科确诊的缺血型CRVO 24例24眼患者行氩激光视网膜光凝联合雷珠单抗玻璃体内注射治疗。观察治疗前及治疗后1wk;1,3,6mo的最佳矫正视力、眼压、眼底病变情况,治疗前和治疗后1,3,6mo的眼底荧光血管造影(FFA)表现和光学相干断层扫描(OCT)测量黄斑中心凹视网膜厚度(CMT)的改变。结果:随诊时间大于6mo。20例(83%)患者视力有不同程度提高,其中17例(71%)患者黄斑水肿明显减轻或消失;4例患者视力维持于就诊时水平。1例治疗前有虹膜新生血管,治疗后1mo虹膜新生血管消退无继发新生血管性青光眼发生。结论:氩激光视网膜光凝联合雷珠单抗玻璃体内注射治疗缺血型CRVO可有效提高视力,促进视网膜出血、渗出及水肿的吸收,同时可减少视网膜静脉阻塞引起的新生血管,对预防继发性新生血管性青光眼的发生有明显效果。

AIM： To evaluate the clinical effects of argon laser photocoagulation combined with intravitreous injection of Lucentis on ischemic central retinal vein occlusion （CRVO） associated with macular edema and neovascular retina. METHODS： This retrospective study analyzed therapeutic effects of argon laser photocoagulation combined with intravitreous injection of Lucentis performed on 24 patients （24 eyes） with CRVO between January in 2012 and May in 2013. Observation was made in terms of clinical data including patients＇ best- corrected visual acuity, intraocular pressure, optical coherence tomography and fluoresce infundus angiography before treatment and lwk, 1, 3, 6mo after treatment. Comparative analysis was made regarding the manifestations by fundus fluorescein angiography （FFA） and the changes of central macular retinal thickness central macular retinal thickness （CMT） by optical coherence tomography （OCT） before treatment and 1, 3, 6too after treatment. RESULTS： Followed for more than 6mo, 20 patients＇ （83%） best- corrected visual acuity were improvedinordinately; 17 patients＇ （71%） macular edema was obviously alleviated or disappeared; 4 patients, visual acuities weren＇t improved. Iris neovascularization gradually disappeared after 1too treatment and secondary neovascular glaucoma didn＇t occur in one patient. CONCLUSION ： Argon laser photocoagulation combined with intravitreous injection of Lucentis is an effective method to treat ischemic central retinal vein occlusion. It can improve visual acuity, promote the absorption of retinal hemorrhage, effusion and macular edema, reduce neovascularizations caused by CRVO and obviously prevent the occurrence of secondary neovascular glaucoma.