大剂量激素联合Avastin治疗Vogt-小柳-原田综合征的临床疗效观察

The clinical effect of therapy of massive corticosteroid combined with Avastin injection into vitreous

目的探讨激素联合Avastin治疗Vogt-小柳-原田病的临床疗效。方法分析2006年6月至2008年6月临床病例28例56眼,所有患者分为A、B两组,A组（15例）患者视网膜水肿及黄斑区水肿较轻,给予大剂量激素冲击治疗;B组（13例）患者明显视乳头水肿,黄斑区水肿,部分患者伴有泡状视网膜脱离,在大剂量激素治疗的同时早期给予玻璃体腔注射Avastin1.25mg/0.05m l。两组治疗时间一致,随访12-18个月,观察其疗效情况。结果A组激素治疗3天后,患者症状改变不明显;治疗后两周6例患者12只眼（40%）视力≥0.6;治疗后1月14例患者28只眼视力≥0.6;治疗后3个月所有患者视力≥0.8,FFA示视网膜高荧光渗漏消失,OCT示视网膜神经上皮层脱离消失。B组玻璃体腔注射Avastin术后第2天,11例患者22只眼（84.6%）眼底视乳头水肿、黄斑区水肿明显减轻;治疗后两周所有患者视力≥0.6;治疗后1月所有患者视力≥0.8,FFA示视网膜高荧光渗漏消失,OCT示视网膜神经上皮层脱离消失。结论大剂量激素联合玻璃体腔注射Avastin治疗Vogt-小柳-原田综合征早期视力提高明显,明显减轻视网膜水肿及黄斑区水肿,缩短病程。

Objective： To study the clinical effect of therapy of massive corticosteroid combined with Avastin injection into vitreous.Methods： The data of 28 patients with VKH syndrome（from Jun,2006 to Jun,2008） were reviewed and analyzed.The patients were divided into two groups.The patients of group A were treated with massive corticsteroid.The patients of group B were treated with massive corticosteroid combined with Avastin injection into vitreous.The treatment duration of two groups was consistent and we observed the effect about 12 to 18 moths following up therapy.Results： The clinical symptoms of group A were not markedly improved after three days of treatment;Visual acuity of 40 percent patients was above 0.6 after 2 weeks.Visual acuity of all patients was above 0.8 after 3 months,and the OCT findings of serous retinal detachement disappeared.The retinal edema of group B improved obviously after two days of surgery of Avastin injection into vitrous and the retinal edema alleviated greatly.Visual acuity of all patients was above 0.6 after 2 weeks.Visual acuity of all patients was above 0.8 after 1 month,and the OCT findings of serous retinal detachement disappeared.Conclution： The visual acuity is improved significantly and the edema of the retina was alleviated obviously after the therapy of massive corticosteroid combined with Avastin injection into vitreous at early stage.This therapy can also shorten the course of the disease.