外伤性脉络膜破裂后新血管形成和黄斑前膜的治疗方法探讨

Explorations of treatment for choroidal neovascularization complicating epiretinal membrane secondary to traumatic choroidal rupture

目的评价玻璃体切除术联合抗血管内皮生长因子（VEGF）治疗外伤性脉络膜破裂后继发脉络膜新血管形成（CNV）和黄斑前膜的效果。 方法回顾性分析9例眼球挫伤造成脉络膜破裂后继发CNV和黄斑前膜的临床资料，所有患者在接受玻璃体切除联合黄斑前膜剥除术后进行雷珠单抗玻璃体内注射至少3次。随访6个月以上。 结果9例手术均顺利完成，在治疗6个月后最佳矫正视力均较术前提高（t＝2.6044，P＝0.019）。所有患者视物变形症状改善，黄斑区前膜已不明显，CNV范围缩小，并且在术后6个月的随访期内保持稳定。 结论采用玻璃体切除术联合抗VEGF药物治疗脉络膜破裂后CNV和黄斑前膜的方法，在6个月的随访期内安全有效。

Objective To evaluate the efficacy of vitrectomy combine with anti-vascular endothelial growth factor （VEGF） therapy for choroidal neovascularization （CNV） and epiretinal membranes secondary to traumatic choroidal rupture. Methods Clinical data of 9 eyes of 9 cases of CNV and epiretinal membrane secondary to traumatic choroidal rupture were analysed retrospectively. After pars plana vitrectomy all cases received ranibizumab intravitreal injection at least 3 times. The follow-up was 6 months. Results All surgeries were performed smoothly. The postoperative best corrected visual acuity and metamorphopsia improved after 6 months （ t = 2. 6044, P = 0. 019）. The epiretinal membrane of macula was not obvious after surgery and the area of CNV regressed remarkably. This condition remained stable during 6 months follow- up. Conclusion Vitrectomy combined with anti-VEGF therapy may be feasible for CNV and epiretinal membranes secondary to traumatic choroidal rupture within 6 months follow-up.