高密度微脉冲激光联合玻璃体内注射雷珠单抗治疗糖尿病性黄斑水肿

High-density micropulse photocoagulation combined with intravitreal injection of ranibizumab for diabetic macular edema

目的观察高密度微脉冲激光联合玻璃体内注射雷珠单抗治疗糖尿病性黄斑水肿(diabetic macular edema,DME)的疗效。方法将31例(31眼)DME患者分2组,A组15例(15眼)行高密度微脉冲激光联合玻璃体内注射雷珠单抗治疗;B组16例(16眼)仅行玻璃体内注射雷珠单抗治疗。观察治疗前后黄斑中心凹视网膜厚度(central macular thickness,CMT)、最佳矫正视力(best corrected visual acuity,BCVA),以及两组各自雷珠单抗的年平均注射次数。结果雷珠单抗年注射次数:A组为(3.67±1.11)次,B组为(9.12±2.63)次,两组相比差异有统计学意义(t=2.05,P<0.05)。两组治疗后CMT均较治疗前降低,差异均有统计学意义(均为P<0.05),但两组治疗前后CMT差值比较差异无统计学意义(t=1.19,P>0.05)。两组治疗后BCVA均较治疗前有所改善,且差异均有统计学意义(均为P<0.05),但两组之间治疗前后BCVA相比差异均无统计学意义(均为P>0.05)。结论高密度微脉冲激光联合玻璃体内注射雷珠单抗与单纯玻璃体内注射雷珠单抗均可有效治疗DME,但前者可以明显减少雷珠单抗的注射次数,患者依从性较好,是治疗DME的一种较好选择。

Objective To investigate the clinical effects of high-density micropulse photocoagulation（HD-SDM）combined with intravitreal injection of ranibizumab for diabetic macular edema（DME）.Methods Thirty-one patients （31 eyes） with DME were randomly divided into two groups.Group A （15 eyes） received HD-SDM combined with intravitreal injection of ranibizumab.Group B （16 eyes） only received intravitreal injection of ranibizumab.The best corrected visual acuity （BCVA） and central macular thickness （CMT） of the two groups before and after treatment were analyzed,and the annual injection times of the two groups were compared.Results The average annual injection times was 3.67±1.11 in group A,and 9.12±2.63 in group B.The difference was significant between the two groups （t=2.05,P〈0.05）.There were significant differences in CMT before and after treatment in both groups （all P〈0.05）.There was no significant difference in CMT between the two groups（t=1.19,P〉0.05）.There were significant differences in BCVA before and after treatment in both groups（all P〈0.05）,but there was no significant difference before and after treatment between the two groups（all P〉0.05）.Conclusion Both HD-SDM combined with intravitreal injection of ranibizumab and single intravitreal injection of ranibizumab are effective for DME,but the combining treatment can remarkably decrease the annual injection times and had a good compliance of patients,is a good choice for DME patients.