玻璃体腔注射雷珠单抗联合激光治疗视网膜分支静脉阻塞继发黄斑水肿的疗效观察

Clinical observation of intravitreous injection with Ranibizumab combined with laser photocoagulation for the treatment of macular edema secondary to branch retinal vein occlusion

目的观察玻璃体腔注射雷珠单抗联合黄斑区格栅样光凝治疗视网膜分支静脉阻塞(BRVO)继发黄斑水肿的疗效和安全性。方法据荧光素眼底血管造影(FFA)对30例(30眼)视网膜分支静脉阻塞继发黄斑水肿患者随机分为2组:第1组(14眼)单纯行黄斑区格栅样光凝(GLP);第2组(16眼)玻璃体腔连续注射3次雷珠单抗0.05ml/(0.5mg),每次间隔1个月,第1次注射雷珠单抗7天后行GLP治疗。随访6个月,观察最佳矫正视力(BCVA)及光学相关断层扫描(OCT)检查黄斑中心凹厚度(CMT)的变化。结果 6个月后两组患者最佳矫正视力(BCVA)均提高,联合治疗组优于单纯GLP组(P<0.05)。OCT显示第1组黄斑中心凹厚度平均降低236.4±113.0μm,第2组平均降低386.6±195.5μm,联合治疗组优于单纯GLP组(P<0.05)。结论联合治疗明显优于单独激光治疗,玻璃体腔内注射雷珠单抗联合黄斑区格栅样光凝术治疗视网膜分支静脉阻塞继发黄斑水肿安全有效。

Objetive To compare the safety and efficacy of intravitreal injection with ranibizumab combined grid laser photocoagulation for the treatment of macular edema secondary to branch retinal vein occlusion（BRVO）.Materials and Methods：Thirty eyes of 30 patients of BRVO were randomized into two groups： Group 1（14 eyes）received grid laser photocoagulation treatment（GLP） alone, Group 2（16 eyes）received three loading doses of intravitreal injection with ranibizumab at monthly interval st（i.e. 0, 1, 2 months） ＋ standard laser treatment 7 days after the 1 injection. Outcome measure noted at 6 months follow-up were the improvement in best-corrected visual acuity（BCVA） and central macular thickness（CMT）.Results At 6 months follow-up, both groups of patients＇ best corrected visual acuity were improved. The combined treatment group was better than simple GLP group（P〈0.05）; OCT display that CMT of groups 1 decreased by an average of 208.7um, CMT of groups 2 decreased by an average of 312.9um, The combined treatment group was better than simple GLP group（P〈0.05）.Conclusion The gain in BCVA and reduction in CMT were better with combination therapy. It is effective and safe in the treatment of macular edema secondary to branch retinal vein occlusion to.