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继发黄斑水肿

Effect of Ranibizumab with macular grid pattern photocoagulation for macular edema caused by branch retinal vein occlusion

目的:评价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继发黄斑水肿的临床疗效。方法:经眼底荧光血管造影及光学相干断层扫描检查确诊的视网膜分支静脉阻塞引起的黄斑水肿患者42例42眼,随机分为玻璃体腔注射雷珠单抗联合黄斑区格栅样光凝治疗组(联合治疗组)和单纯黄斑区格栅样光凝治疗组(光凝治疗组),比较两组患者治疗后1、3、6mo的最佳矫正视力(best corrected visual acuity,BCVA)、黄斑中心视网膜厚度(central macular thickness,CMT)以及有无并发症发生情况。结果:联合治疗组治疗后第1、3、6mo最佳矫正视力及黄斑中心视网膜厚度与治疗前比较,均有统计学差异(P<0.05)。激光治疗组治疗后1mo时BCVA及CMT改善不明显,与治疗前比较无统计学差异(P>0.05),治疗后3、6mo时BCVA及CMT逐步改善,与治疗前比较有统计学差异(P<0.05)。联合治疗组与激光治疗组治疗后第1、3、6mo,两组间BCVA及CMT比较有统计学差异(P<0.05)。结论:玻璃体腔注射雷珠单抗联合黄斑区格栅样光凝治疗可有效减轻视网膜分支静脉阻塞所致黄斑水肿,提升视力,其作用较单纯黄斑区格栅样光凝治疗起效更迅速,能更好地减轻黄斑水肿。

AIM：To evaluate the effect of Ranibizumab（lucentis）combined with macular grid pattern photocoagulation in the treatment of macular edema caused by branch retinal vein occlusion（BRVO）.METHODS：Forty-two patients（42 eyes） diagnosed as macular edema caused by BRVO by fundus fluorescence angiography（FFA） and optical coherence tomography（OCT） were enrolled.The patients were randomized divided into two groups：group 1（combined therapy group） received lucentis intravitreal injection combined with macular grid pattern photocoagulation;group 2（photocoagulation therapy group） received macular grid pattern photocoagulation only.The best corrected visual activity（BCVA）,central macular thickness（CMT） and complications were compared between the two groups at1,3 and 6mo after treatments.RESULTS：Compared to before treatments,at 1,3 and6 mo after treatments：the changes of BCVA and CMT were significant different in group 1（P〈 0.05）.Compared with before treatments,at 1mo after treatments：changes of BCVA and CMT had no significant differences in group 2（P〉 0.05）;but at 3 and 6mo after treatments：BCVA and CMT improved gradually and the differences were significant in group 2（P〈 0.05）.The changes of BCVA and CMT between the two groups were statistically significant at 1,3 and 6mo after treatments（P〈 0.05）.CONCLUSION：Ranibizumab intravitreal injection combined with macular grid pattern photocoagulation therapy can effectively reduce macular edema caused by BRVO,improve vision acuity.Compared with macular grid pattern photocoagulation therapy,combination therapy works more quickly,and reduces macular edema more.