抗VEGF治疗在新生血管性青光眼治疗中的应用

The application of anti-VEGF in the treatment of neovascular glaucoma

目的评估抗血管内皮生长因子(VEGF)药物在新生血管性青光眼治疗中的作用。方法选取新生血管性青光眼(NVG)患者58人63只眼,男性40人,女性18人,平均年龄(65.81±14.68)岁。根据患者是否接受抗VEGF治疗分为抗VEGF组和对照组。2组患者除抗VEGF治疗外,还进行其他治疗如滤过术、青光眼阀植入术、睫状体冷凝或光凝及视网膜光凝,且构成差异无统计学意义(P>0.05)。对2组患者治疗前后的眼压和视力进行统计学分析。结果抗VEGF组与对照组治疗后眼压均有明显下降。抗VEGF组自(49.35±12.57)mmHg(1 mmHg=0.133 kPa)下降至(14.6±7.29)mmHg;对照组自(52.34±10.67)mmHg下降至(17.1±6.93)mm Hg。2组治疗后1周至治疗后3个月各时点眼压之间比较,差异均无统计学意义(P>0.05)。抗VEGF组与对照组治疗后视力差异无统计学意义(P>0.05)。结论抗VEGF能够抑制虹膜及视网膜上新生血管的生成和发展,但在新生血管性青光眼的治疗中,尚无法明显地改善预后。

OBJECTIVE To evaluate the affection of the anti-VEGF in the treatment of neovascular glauco-ma. METHODS 58cases （63 eyes）, 40 males and 18 females, with average age of 65.81±14.68, were selected and been separated into two groups by weather got the Lucentis intraocular injection. No significant different between the two groups of the cases that get other treatment methods like trabeculactomy, glaucoma valve implantation, cy-clocryotherapy, cyclophotocoagulation or pan retinal photocoagulation. Intraocular pressure （IOP） and visual acurity （VS） before and after the combine treatment were been evaluated. RESULTS The IOP declined dramatically in both anti-VEGF group and control group. The IOP drops from （49.35±12.57） mm Hg （1 mm Hg=0.133 kPa） to （14.6±7.29） mm Hg in anti-VEGF group, but no significant different was seen among the post-treatment groups （P〉.05）. The IOP drops from （52.34±10.67） mm Hg to （17.1±6.93） mm Hg in control group, no significant different was seen among the post-treatment groups too （P＆gt;0.05）, and no significant different was seen between treatment group and no-treatment group at any time point （P〉0.05）. There was no significant different was seen in VS too （P〉0.05）. CONCLUSIONS Anti-VEGF treatment could control the happen and develop of the neovascularazation of iris and retinal effectively, but could not improve the prognosis of neovascular glaucoma.