微脉冲激光联合抗VEGF药物治疗BRVO继发的黄斑水肿

Subthreshold micropulse laser photocoagulation with intravitreous anti-VEGF for macular edema secondary to branch retinal vein occlusion

目的:探讨阈值下微脉冲激光联合玻璃体注射抗血管内皮生长因子(vascular endothelial growth factor,VEGF)治疗视网膜分支静脉阻塞(branch retinal vein occlusion,BRVO)继发黄斑水肿的疗效。方法:回顾性分析经荧光眼底血管造影(FFA)和相干光断层扫描(OCT)检查确诊为BRVO且病史<3mo的BRVO继发黄斑水肿患者16例16眼,8眼予玻璃体腔注射抗VEGF药物治疗联合577nm阈值下微脉冲激光(微脉冲组),8眼予玻璃体腔注射抗VEGF药物治疗联合传统格栅样激光光凝(格栅光凝组)。观察治疗前及治疗后6mo两组患者的最佳矫正视力(best corrected visual acuity,BCVA)及黄斑中心凹厚度(central foveal thickness,CFT)。结果:治疗后6mo的BCVA:微脉冲组由治疗前的0.34±0.18提高到0.07±0.01,差异有统计学意义(P<0.01),格栅光凝组由治疗前的0.75±0.52提高到0.15±0.18,差异有统计学意义(P<0.01),两组治疗后比较差异无统计学意义(P>0.05)。治疗后6mo的CFT:微脉冲组由治疗前的362.25±119.33μm降低至232.25±56.56μm,差异有统计学意义(P<0.05),格栅光凝组由治疗前的419.75±96.30μm降低至229.25±43.96μm,差异有统计学意义(P<0.01),两组治疗后比较差异无统计学意义(P>0.05)。结论:治疗CRVO合并黄斑水肿,577nm阈下微脉冲激光联合玻璃体腔注射抗VEGF药物治疗与传统格栅光凝联合玻璃体腔注射抗VEGF药物治疗具有同样的良好疗效。

AIM： To investigate the micropulse 577nm laser efficacy of subthreshold photocoagulation with intravitreous anti-vascular endothelial growth factor（ anti- VEGF） treatment for macular edema secondary to branch retinal vein occlusion （BRVO）. METHODS. A retrospective case series study was sixteen patients （16 eyes） of macular edema secondary to BRVO whose course was not more than 3too were examined by fundus fluoresceine angiography （FFA） and optical coherence tomography （OCT）. Eight eyes were given subthreshold micropulse 577nm laser with anti- VEGF treatment （micropulse laser group）. Meantimeanother 8 eyes were given conventional grid laser photocoagulation with anti-VEGF treatment （grid laser group）. The followed up was 6too. The best corrected visual acuity （BCVA） and central foveal thickness （CFT） were analyzed. RESULTS： The baseline BCVA of the micropulse laser group was 0.34±0.18 （LogMAR） and was improved to 0.07±0.01 （ P〈0.01 ） at last follow- up while the grid laser group was improved from 0.75±0.52 （LogMAR） to 0.15± 0.18 （P〈0.01）. CFT of the micropulase laser group at baseline was 362.25±119.33μm and decreased to 232.25± 56. 56μ m （ P〈 0.01 ） at the last follow- up while the grid laser group was from 419.75±96.30μ m decreased to 229.25± 43.96 μ m （P〈0.01）. For both BCVA and CFT, there were no statistic differences between the two groups （ P〉0, 05）. CONCLUSION. Subthreshold micropulse 577nm laser with anti VEGF and conventional grid laser photocoagulation with anti-VEGF had equivalent effects on the treatment of macular edema secondary to BRVO.