单独注射雷珠单抗与联合视网膜光凝治疗继发性黄斑水肿的效果比较

Comparison on the efficacy between the ranibizumab injection alone and ranibizumab injection combined with retinal laser grid photocoagulation for the treatment of secondary macular edema

目的比较单独玻璃体内注射雷珠单抗（ranibizumab）与联合格栅样光凝治疗视网膜分支静脉阻塞（BRVO）继发黄斑水肿的临床效果。方法BRVO继发黄斑水肿42例（42眼），随机分为对照组（单纯玻璃体内注射雷珠单抗）和观察组（雷珠单抗联合黄斑区视网膜532nm绿激光格栅样光凝）各21例。治疗后1个月比较两组有效率、视力和黄斑中心区视网膜厚度的变化。结果观察组总有效率为90．4％，对照组总有效率为71．4％，观察组治疗效果明显优于对照组（X^2=5．990，P=0．000）。两组治疗前视力差异无统计学意义（P=0．23）；治疗后BCVA（10gMAR）分别为（0．38±0．15）和（0．49±0．17）均有明显提高，且治疗组优于对照组，差异有统计学意义（t=2．853，P=0．04）。两组治疗前黄斑中心区视网膜厚度差异无统计学意义，治疗后分别为（187．0±164．2）μm、（265．1±177．3）μm。均明显降低，且观察组低于对照组，差异有统计学意义（t=3．123，P=0．03）。结论玻璃体内注射雷珠单抗联合黄斑格栅样光凝对于BRVO继发的黄斑水肿治疗效果良好。优于单纯玻璃体内注射雷珠单抗。

Objective To compare the efficacy of ranibizumab intravitreal injection and ranibizumab injection combined with macular laser grid photocoagulation for the treatment of macular edema secondary to branch retinal vein occlusion（BRVO）. Methods Forty-two eyes of 42 patients with macular edema due to BRVO were collected. The patients were randomly divided into control group of 21 cases which underwent intravitreal injection of ranibizumab, and observation group of 21 cases which underwent intravitreal injection of ranibizumab combined with 532 nm green laser grid photocoagulation. Compared the effective rate, visual acuity and thickness of macular among two groups after 1 month treatment. Results The total effective rate of observation group was 90.4% and the control group was 71.4%. The observation group therapy efficacy was significantly better than the control group （X^2 = 5. 990, P = 0. 000）. There was no significant difference between two groups in vision acuity before treatment （ P 〉 0.05 ） ; after the treatment, the best corrected vision（ BCVA, logMAR） of observation group and control group improved obviously to （0.46±0.15 ）, （0.31±0. 12） respectively. The observation group of BCVA was better than that of control group after treatment （t = 2. 853, P = 0. 040）. Before treatment, there was no significant difference between the two groups in thickness of macular （P 〉 0.05）. After the treatment, the thickness of macular of observation group and control group were （187.0±164.2 ）μm, （265. 1±177. 3 ）μm, respectively. The observation group was thinner than control group after treatment （ t = 3. 123, P = 0. 030 ）. Conclusion Intravitreal injection of ranibizumab combined with macular laser grid photocoagulation is effective for the treatment of maeular edema caused by BRVO.