Ranibizumab治疗糖尿病性黄斑水肿短期疗效观察

Short-term efficacy of Ranibizumab for diabetic macular edema

目的观察玻璃体内注射Ranibizumab治疗糖尿病性黄斑水肿的短期疗效。方法在我院诊断为糖尿病性黄斑水肿患者34例（46眼）,应用药物治疗、激光治疗或手术治疗,黄斑水肿无改善或持续加重,应用Ranibizumab 0.5 mg（0.05 m L）玻璃体内注射,术后随访12个月,根据眼底、视力及OCT检查决定是否再次注射。结果所有患者玻璃体内注射Ranibizumab无局部和全身并发症。每眼注射次数为1~4次,平均2.39次,重复注射时间为注射后1.0~1.5个月。46眼注射后12个月视力不同程度提高者44眼,2眼保持不变,注射后7 d、1个月、6个月、12个月最佳矫正视力分别提高2.32个、3.47个、5.34个和6.25个字母。OCT检查结果显示注射Ranibizumab后黄斑区视网膜水肿明显减轻,首次注射后7 d、1个月、6个月、12个月黄斑中心视网膜厚度值分别为（425±38）μm、（372±41）μm、（294±32）μm和（276±25）μm,与注射前（647±42）μm相比差异均有统计学意义（均为P〈0.05）。结论对于糖尿病性黄斑水肿患者,玻璃体内注射Ranibizumab具有很好的安全性和有效性,可明显促进黄斑水肿吸收,提高视力,OCT检查可作为评价是否需要再次注射的标准。

Objective To study the short-time efficacy of intravitreal injection of Ranibizumab in patients with diabetic macular edema.Methods Thirty-four patients（46 eyes） with diabetic macular edema who had medicine,laser coagulation or operation before were studied.They received intravitreal injection of 0.05 mL（0.5 mg） Ranibizumab once.Further injection was required according to patients＇ visual acuity or OCT results at 12 months follow-up time.Results There was no local or systemic complication in all patients.Each eye received 1-4 injections（mean 2.39）.Further injection was performed at 1.0- 1.5 months after first injection.The best corrected visual acuity at 7 days,1 month,6 months and 12 months after injection increased 3.32 letters,3.47 letters,5.34 letters and 6.25 letters,respectively.The mean central retinal thickness at 7 days,1 month,6 months and 12 months after injection were（425± 38） μm,（372 ±41） μm,（294 ±32） μm,（276 ±25） μm,respectively,there were significant differences compared with before injection（647±42） μm（all P〈0.05）.Conclusion Intravitreal injection of Ranibizumab is effective and safe for diabetic macular edema,can improve the visual acuity and promote the absorption of macular edema.OCT examination is one of important manners for determining the further injection.