玻璃体内注射雷珠单抗联合氩激光治疗缺血性新生血管性青光眼的临床观察

Clinical Observation of Intravitreal Injection of Ranibizumab Combined with Argon Laser Therapy in the Treatment of Ischemic Neovascular Glaucoma

目的:观察玻璃体内注射雷珠单抗联合氩激光治疗缺血性新生血管性青光眼的疗效与安全性。方法:选择2014年3月-2016年3月我院收治的新生血管性青光眼患者166例为研究对象,按随机数字表法分为对照组和观察组,各88例(患眼分别为117、125眼),两组患者均采用氩激光全视网膜光凝术治疗,每周2次,治疗1个月;观察组患者在此基础上于玻璃体内注射雷珠单抗注射液(0.5 mg),每周1次,治疗1个月。观察两组患者的临床疗效,治疗前、治疗后1周、治疗后1个月时的眼压和视力,并记录不良反应发生情况。结果:治疗1个月后,观察组患者的治疗总有效率为95.20%,显著高于对照组的76.92%,差异有统计学意义(P<0.05)。治疗后1周,观察组患者的眼压显著低于治疗前及对照组同期,视力情况显著优于治疗前及对照组同期,差异均有统计学意义(P<0.05);治疗后1个月,两组患者的眼压均显著降低,视力均显著恢复,且观察组患者的眼压下降、视力恢复情况较之对照组更为显著,差异均有统计学意义(P<0.05或P<0.01)。两组患者不良反应发生率分别为3.41%、2.27%,差异无统计学意义(P>0.05)。结论:玻璃体内注射雷珠单抗联合氩激光治疗缺血性新生血管性青光眼疗效优于单用氩激光治疗,能显著降低患者眼压,恢复患者视力,且安全性较高。

OBJECTIVE：To observe the clinical efficacy and safety of intravitreal injection of ranibizumab combined withargon laser therapy in the treatment of ischemic neovascular glaucoma. METHODS：A total of 166 patients with neovascularglaucoma selected from our hospital during Mar. 2014-Mar. 2016 were divided into control group and observation group accordingto random number table,with 88 cases in each group（there were 117 and 125 eyes respectively）. Both groups received argon laserphotocoagulation therapy twice a week for 1 month. Observation group was additionally given intravitreal injection of Ranibizumabinjection（0.5 mg）once a week,for 1 month. Clinical efficacies of 2 groups were observed,and the intraocular pressure and visualacuity of 2 groups were observed before treatment,1 week and 1 month after treatment. The occurrence of ADR was recorded.RESULTS：After 1 month of treatment,total response rate was 95.20% in observation group,which was significantly higher than76.92% in control group,with statistical significance（P〈0.05）. After 1 week of treatment,intraocular pressures of observationgroup were lower than before treatment and control group at the same time,while visual acuity was better than before treatment andcontrol group at the same time,with statistical significance（P〈0.05）. After 1 month of treatment,intraocular pressures of 2 groupswere decreased significantly and visual acuity was significantly improved;intraocular pressure was decreased and visual acuity wasimproved more significantly in observation group than control group,with statistical significance（P〈0.05 or P〈0.01）. The incidencesof ADR of 2 groups were 3.41% and 2.27%,without statistical significance（P〉0.05）. CONCLUSIONS：The ischemic intravitrealinjection of ranibizumab combined with argon laser therapy is better than argon laser therapy alone in the treatment of ischemicneovascular glaucoma,and can significantly reduce intraocular pressure and improve visual acuity with good safety.