玻璃体腔注射ozurdex或康柏西普治疗黄斑水肿的临床疗效

Clinical efficacy of intravitreal injection of ozurdex or conbercept in the treatment of macular edema

目的观察玻璃体腔注射地塞米松缓释剂ozurdex或康柏西普治疗黄斑水肿的疗效。方法黄斑水肿患者40例(40眼),随机分为两组,每组20眼。A组采用眼内注射ozurdex 0.7 mg;B组采用玻璃体腔注射康柏西普0.05 ml。两组均行药物注射1次。于治疗后1周、1个月和3个月时行光学相干断层扫描(OCT),测量黄斑中心区视网膜厚度(CMT),比较两组患者的裸眼视力和眼压变化,观察不良反应发生情况。结果与治疗前比较,两组患者治疗后1周及1个月CMT减少,裸眼视力提高(P<0.05)。治疗3个月后,A组的CMT小于术前[(276.30±71.82)μm vs.(549.75±160.78)μm],也小于B组的(469.75±135.92)μm (P<0.05);治疗3个月后,B组CMT与术前相仿[(469.75±135.92)μm vs.(477.55±130.86)μm](P>0.05)。治疗3个月后,A组的裸眼视力高于术前(0.348±0.120 vs.0.127±0.680),也高于B组的0.188±0.130(P<0.05)。随访期间,A组出现1例高眼压,应用降眼压药物后恢复正常;两组均未见视网膜脱离、眼内容炎和玻璃体积血等并发症。结论玻璃体腔注射ozurdex和康柏西普均能有效减轻黄斑水肿,但ozurdex的作用比康柏西普相对较长。

Objectve To observe the efficacy of intravitreal injection of dexamethasone sustained release agent ozurdex or conbercept in the treatment of macular edema.Methods Forty patients with macular edema were randomly devided into two groups with 20 cases each.The patients in group A were treated with intravitreal injection of ozurdex 0.7 mg once and those in group B were treated with intravitreal injection of conbercept 0.05 ml once. The retinal thickness in the central macular area(CMT) was measured and the uncorrected visual acuity(UVA) and intraocular pressure were compared between the two groups.The adverse responses were observed during three months follow-up.Results At one week and one month after injection,CMT was decreased and UVA was increased significantly in both groups(P<0.05).At three months after injection,CMT of group A was less than that before injection [(276.30±71.82)μm vs.(549.75±160.78)μm] and less than(469.75±135.92)μm of group B(P<0.05).At three months after injection,UVA of group A was more than that before injection(0.348±0.120 vs.0.127±0.680) and more than 0.188±0.130 of group B(P<0.05).During follow-up,bulbi hypertonia was seen in one case of group A,which returned to nomal after treatment with intraocular pressure lowering drugs.Conclusion Intravitreal injection of ozurdex or conbercept is effective in the treatment of macular edema,in which ozurdex is better than conbercept in providing a relatively longer lasting effect.