康博西普玻璃体腔注射联合视网膜激光光凝治疗视网膜分支静脉阻塞继发黄斑水肿效果观察

Efficacy of combination therapy with conbercept and retinal laser photocoagulation for treating macular edema secondary to branch retinal vein occlusion

目的探讨康博西普眼部注射液玻璃体腔注射联合视网膜激光光凝术治疗视网膜分支静脉阻塞(BRVO)继发黄斑水肿的临床应用及其疗效。方法选择2013年8月至2014年12月西安市第四医院眼科收治的58例(58眼)BRVO继发黄斑水肿患者,采用随机数字表法将患者分为研究组和对照组各29例(29眼),研究组给予玻璃体腔注射康博西普眼部注射液[在无菌层流手术室以0.05 ml(10 mg/ml)进行玻璃体腔注射,每月1次,连续3个月]+激光光凝治疗,对照组单用激光光凝治疗。于治疗后1、4、12、24周分别测定并对比两组患者的最佳矫正视力(BCVA)、黄斑中心视网膜厚度(CMT)和眼内压(IOP)。结果术前研究组和对照组的BCVA、CMT值相近(P均>0.05);术后4、12、24周两组患者的BCVA较术前显著增高、CMT值较术前显著降低(P均<0.05),术第12、24周研究组患者的BCVA值显著高于对照组、CMT值显著低于对照组患者(P均<0.05)。术前、术后12、24周两组患者的IOP测定值组间、组内比较差异均无统计学意义(P均>0.05)。两组患者均无感染、无菌性眼内炎、玻璃体积血、视网膜脱离等并发症以及黄斑水肿复发发生。结论康博西普眼部注射液玻璃体腔注射联合视网膜激光光凝术治疗BRVO继发黄斑水肿较单纯激光光凝术具有更显著的临床疗效。

Objective To investigate the clinical application and efficacy of combination therapy with intravitreal injection of conbercept and retinal laser photocoagulation for treating macular edema secondary to branch retinal vein occlusion（ BRVO）. Method A total of 58 patients（ 58 eyes） with macular edema secondary to BRVO treated in Department of Ophthalmology of the Fourth Hospital of Xi’an from August 2013 to December 2014 were divided into research group and control group by digital random grouping method（ n = 29 each）. The intravitreal injection with conbercept eye injection[0. 05 ml（ 10 mg/ml）,once a month for three months]in the sterile laminar flow operation room plus laser photocoagulation therapy were performed in research group,and the laser photocoagulation therapy was performed alone in control group. At1-,4-,12-,24-week after treatment,the best corrected visual acuity（ BCVA）,central macular retinal thickness（ CMT）,intraocular pressure（ IOP） were measured and compared between two groups. Results There were no significant differences in preoperative BCVA and CMT values in two groups（ all P 〉 0. 05）. At 4-,12-,24-week after treatment,BCVA value significantly increased and CMT value significantly decreased compared with pretreatment in two groups（ all P 〈 0. 05）. At12-,24-week after treatment,BCVA value of research group were statistically higher than that of control group,while CMT value in research group were statistically lower than that in control group（ all P 〈 0. 05）. There were no significant differences in IOP before operation and 12 weeks and 24 weeks after operation between two groups（ all P 〉 0. 05）. The complications such as infection,aseptic endophthalmitis,vitreous hemorrhage,retinal detachment and edema relapse were not found in two groups. Conclusion The clinical effect of combination therapy with intravitreal injection of conbercept and retinal laser photocoagulation is superior to retinal laser photocoagulation therapy alone for treating macular edema secondary to BRVO.