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无灌注区、黄斑区双激光方案在视网膜静脉分枝阻塞继发黄斑水肿患者中的应用分析

Analysis of the application of dual laser protocol in non-perfusion area and macular area in patients with macular edema secondary to branch retinal vein occlusion
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摘要 目的 探讨无灌注区、黄斑区双激光方案在视网膜静脉分枝阻塞(BRVO)继发黄斑水肿(ME)患者中的应用分析。方法 根据随机数字表法将浙江省丽水市人民医院2021年5月至2022年5月收治的150例BRVO继发ME患者分为对照组(雷珠单抗玻璃体腔内注射治疗)和双激光组(雷珠单抗联合无灌注区、黄斑区双激光治疗),各75例。治疗后3个月,比较两组临床效果、恢复情况[最佳矫正视力(BCVA)、眼内压(IOP)、黄斑中心视网膜厚度(CMT)]、黄斑区血流情况及荧光素眼底血管造影检查结果。结果 双激光组疗效优于对照组(P<0.05)。治疗后3个月,两组BCVA高于治疗前,IOP、CMT低于治疗前,且双激光组BCVA高于对照组,IOR、CMT低于对照组(P<0.05)。治疗后3个月,两组浅、深层毛细血管血流密度均高于治疗前,且双激光组高于对照组(P<0.05)。双激光组囊样渗漏、弥漫渗漏、局部渗漏发生率均低于对照组(P<0.05)。结论 玻璃体腔内注射雷珠单抗联合无灌注区、黄斑区双激光治疗BRVO继发ME可提高雷珠单抗的效果,促进患者视力恢复,还可改善黄斑区血流状况,减少血管渗漏发生。 Objective To investigate the application of dual laser protocol in non-perfusion area and macular area in patients with macular edema(ME)secondary to branch retinal vein occlusion(BRVO).Methods According to the random number table method,150 patients with BRVO secondary ME admitted to Lishui People’s Hospital of Zhejiang Province from May 2021 to May 2022 were divided into control group(intravitreal injection treatment of Ranibizumab)and dual laser group(Ranibizumab combined with dual laser treatment of non-perfusion area and macular area),with 75 cases each.Three months after treatment,the clinical effects of the two groups were compared,and the recovery conditions(best corrected visual acuity[BCVA],intraocular pressure[IOP],central macular thickness[CMT]),macular blood flow,and fluorescein fundus angiography results were compared.Results The effect of dual laser group was better than that of control group(P<0.05).At three months after treatment,BCVA in both groups were higher than those before treatment,IOP,CMT in both groups were lower than those before treatment,and BCVA of dual laser group were higher than those of control group,IOP and CMT were lower than those of control group(P<0.05).At three months after treatment,the blood density of shallow and deep capillary in both groups were higher than those before treatment,and those of dual laser group were higher than those of control group(P<0.05).The incidences of cystoid leakage,diffuse leakage,and local leakage in dual laser group were all lower than those in control group(P<0.05).Conclusion Intravitreal injection of Ranibizumab combined with dual laser in non-perfusion area and macular area in the treatment of BRVO secondary ME can improve the therapeutic effect of Ranibizumab,promote visual recovery of patients,improve blood flow in macular area,and reduce the occurrence of vascular leakage.
作者 汤丽燕 李俊 孙巧红 陈利双 TANG Liyan;LI Jun;SUN Qiaohong;CHEN Lishuang(Department of Ophthalmology,Lishui People’s Hospital,Zhejiang Province,Lishui323000,China;Department of Opht-halmology,Ningbo Eye Hospital,Zhejiang Province,Ningbo315000,China)
出处 《中国医药导报》 CAS 2024年第9期116-120,共5页 China Medical Herald
基金 浙江省医药卫生科技计划项目(2019KY632)。
关键词 雷珠单抗 无灌注区 黄斑区 视网膜静脉分枝阻塞 黄斑水肿 最佳矫正视力 黄斑中心视网膜厚度 眼内压 Ranibizumab Non-perfusion area Macular area Branch retinal vein occlusion Macular edema Best corrected visual acuity Central macular thickness Intraocular pressure
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