玻璃体内注射雷珠单抗(Ranibizumab)治疗视网膜静脉阻塞继发黄斑水肿

Intravitreal injection of ranibizumab for macular edema secondary to retinal vein occlusion

目的初步探讨玻璃体内注射雷珠单抗治疗视网膜静脉阻塞继发黄斑水肿的疗效及安全性。方法 回顾性分析2012年7月至2013年6月就诊于我院眼科的视网膜静脉阻塞继发黄斑水肿患者26例26眼,其中视网膜中央静脉阻塞11例11眼,视网膜分支静脉阻塞15例15眼;病程4～11个月;均给予患眼玻璃体内注射雷珠单抗0.05mL（0.5mg）,比较治疗前及治疗后1d、1周、1个月、3个月最佳矫正视力、眼压,同时于治疗前及治疗后1周、1个月、3个月使用光学相干断层扫描行黄斑中心凹视网膜厚度测量,观察用药后效果。结果 治疗前及治疗后ld、1周、1个月、3个月患眼的最佳矫正视力分别为0.08±0.04、0.13±0.05、0.25±0.09、0.31±0.14、0.29±0.12,治疗后各时间点均较治疗前明显提高,差异均有统计学意义（均为P〈0.05）;治疗前及治疗后各时间点眼压均在正常范围,差异均无统计学意义;治疗前及治疗后1周、1个月、3个月患眼的黄斑中心凹视网膜厚度分别为（447.57±116.67）μm、（371.48±83.74）μm、（246.32±34.51）μm、（249.40±47.87）μm,治疗后黄斑水肿明显改善,与治疗前相比差异均有统计学意义（均为P〈0.05）。治疗后2眼局部球结膜下出血,未见严重不良反应发生。结论 玻璃体内注射雷珠单抗可以提高视网膜静脉阻塞继发黄斑水肿患者的视力,减轻黄斑水肿,治疗后眼压正常,且无明显不良反应。

Objective To evaluate the clinical effects and safety of intravitreal injection of ranibizumab for macular edema secondary to retinal vein occlusion （RVO）. Methods Twenty-six patients （26 eyes） with macular edema secondary to RVO from July 2012 to June 2013 in our hospital were retrospectively analyzed,including ll cases with CRVO,15 cases with BRVO. The duration was from 1 month to ll months. All patients received intravitreal injection of 0.05 mL （0.05 mg） ranibizumab. The best cor- rected visual acuity and intraocular pressure were observed before treatment and l day, 1 week, 1 month,3 months after treatment, the central macular thickness was measured by OCT before treatment and 1 week, 1 month, 3 months after treatment, and clinical effects were observed. Results The best corrected visual acuity before treatment and 1 day,1 week,1 month,3 months after treatment were 0.08 ±0.04,0. 13 ±0.05,0.25 ±0.09,0.31 ± 0. 14,0.29± 0. 12, respectively, after treatment were higher than beforetreatment （all P 〈 0.05 ）. The intraocular pressure before and after treatment were normal. The central macular thickness before treatment and 1 week, 1 month, 3 months after treatment were （447.57 ± 115. 67） μm, （371.48 ± 83.74） μm, （ 245.32 ± 34.51 ） μm, （ 249.40 ± 47.87 ） μm, respectively, after treatment were lower than before treatment （ all P 〈 0.05 ）. After treatment, only 2 patients had conjunctival hemorrhage,no other serious complication was seen. Conclusion Intravitreal injection of ranibizumab for macular edema secondary to RVO can improve the visual acuity and relieve macular edema, and the intraocular pressure after treatment is normal with no serious complication.