玻璃体内注射贝伐单抗联合视网膜激光光凝治疗糖尿病性黄斑水肿

Efficacy of intravitreal injection of Bevacizumab with laser photocoagulation for diabetic macular edema

目的:探究玻璃体内注射贝伐单抗联合视网膜激光光凝治疗糖尿病黄斑水肿的治疗效果以及分析此方法的安全性。方法:选取2014-02/2015-03期间于我院确诊并治疗的69例82眼糖尿病黄斑水肿,随机平均分为对照组与观察组,每组41眼。观察组患者行玻璃体内注射贝伐单抗联合视网膜激光光凝治疗,对照组行单纯视网膜激光光凝治疗。治疗后观察并对比两组患者最佳矫正视力情况(BCVA)、黄斑中心凹厚度(CMT)、荧光素眼底血管造影改变(FFA)以及眼压变化等并发症情况。结果:观察组于治疗后1、3、6mo BCVA、CMT较治疗前有明显改善(P<0.05);对照组治疗前后BCVA未见明显提高(P>0.05),CMT较治疗前有所降低(P<0.05),但FFA结果 6mo后反弹。观察组较对照组在BCVA、CMT方面差异具有统计学意义(P<0.05),且两组治疗后1、3、6mo均未发生眼部及全身性并发症。结论:玻璃体内注射贝伐单抗联合视网膜激光光凝治疗糖尿病黄斑水肿治疗效果更优,而且基本无眼部及全身性并发症。

AIM ： To study the therapeutic effect of intravitreal injection of Bevacizumab combined with laser photocoagulation for diabetic macular edema.METHODS： Sixty- nine cases（ 82 eyes） with diabetic macular edema in our hospital formFebruary 2014 to M arch 2015 were selected and they were randomly divided into two groups（ 41 eyes in each group）. The observation group were given the combination treatment with intravitreal injection of bevacizumab and laser photocoagulation. The control group was given the laser photocoagulation only. The best corrected visual acuity（ BCVA）,the central macular thickness（ CMT）,the results of fundus fluorescein angiography（ FFA）,and the intraocular pressure between two groups were observed and compared. RESULTS： BCVA and CMT of the observation group became better at 1,3 and 6mo after treatment（ P〈0. 05）.BCVA of the control group had no changes（ P〉0. 05） and CM T decreased at 1,3 and 6mo（ P〈0. 05）,but the result of FFA rebounded at 6mo. There were significant differences between two groups on BCVA and CM T after treatment（ P〈0. 05）. None of patients in two groups got any local or systemic complication at 1,3 and 6mo after treatment. CONCLUSION： Intravitreal injection of bevacizumab combined with laser photocoagulation for diabetic macular edema is much more effective and has less complication. It is worth promoting in clinical application.