玻璃体腔注射Lucentis联合治疗增殖性糖尿病性视网膜病变合并虹膜新生血管的临床观察

Intravitreal Lucentis as a Adjuvant Treatment for Proliferative Diabetic Retinopaty Complicated with Iris Neovasucularization

目的:探讨玻璃体腔注射Lucentis联合玻切术及视网膜光凝治疗增殖性糖尿病性视网膜病变引起虹膜新生血管的疗效观察。方法:回顾性分析从2012年6月至2013年7月在武汉大学人民医院眼科中心确诊为增殖性糖尿病性视网膜病变合并虹膜新生血管患者21例(25眼)。每眼均玻璃体腔注射Lucentis 0.5mg/0.1ml,测量术后第1天,第3天,第7天,1个月,2个月视力、眼压及观察虹膜新生血管消退情况。根据眼底视网膜病变程度,于术后1周内21眼行玻切术及视网膜光凝,其中8眼为虹膜新生血管性青光眼,8眼为玻璃体积血,5眼为牵拉性视网膜浅脱。4眼仅行视网膜光凝。结果:与术前视力相比较,术后第1、3、7天、1个月及术后2月视力均有不同程度的提高。与术前眼压相比,术后第1、3、7天、1、2月眼压降低,均有统计学差异。与术前虹膜新生血管分级相比,术后第1、3,7天、1、2月虹膜新生血管分级下降,均有统计学差异。结论:Lucentis联合治疗增殖性糖尿病性视网膜病变引起虹膜新生血管疗效明确,可为早期行眼底激光、玻切术提供手术时机,但每次注药维持时间、每次注射量及远期多次注药频率、并发症等尚需进一步观察。

Objective：To evaluate the effect of intravitreal injection of Lucentis for visual acuity（VA）,intraocular pressure（IOP）and iris neovasucularization grade of proliferative diabetic retinopaty complicated with iris neovasucularization.Methods：A clinical retrospective study of twenty-one cases（twenty-five eyes）diagnosed in our hospital eye centre was extracted since June 2012 to July2013.We observed index including VA,IOP and iris neovasucularization grade in 1st day,3rd day,seventh day,1st month and 2nd month after intravitreal injection of Lucentis.As for different complications such as vitreous hemorrhage,neovascular glaucoma and tractional retinal detachment,pars plana vitrectomy and retinal photocoagulation were conjunctionally operated in one week after Lucentis was injected.Results：Compared with preoperative VA,postoperative VA had improved by different degrees in every times.Simultaneously,postoperative IOP,in common with postoperative iris neovasucularization grade had decreased compared with preoperative ones.Conclusion：Intravitreal Lucentis has a promotive effect for treatment of proliferative diabetic retinopaty complicated with iris neovasucularization so as to provide a window phase for laser photocoagulation and vitrorectomy.However,injection times,injection intervals and complcations will need further efforts.