雷珠单抗玻璃体腔注射辅助显微手术治疗对新生血管性青光眼患者血管内皮生长因子和血小板衍生生长因子含量的影响

Effect of Intravitreal Injection of Ranibizumab Assisted Microsurgery on the Contents of Vascular Endothelial Growth Factors and Platelet-derived Growth Factors in Patients with Neovascular Glaucoma

目的研究雷珠单抗玻璃体腔注射辅助显微手术治疗对新生血管性青光眼(NVG)患者血管内皮生长因子(VEGF)和血小板衍生生长因子(PDGF)含量的影响。方法对我院32例(32眼)NVG患者资料进行回顾和分析,所有患者接受玻璃体腔注射雷珠单抗、小梁切除术和全视网膜光凝治疗。比较患者治疗前后眼压、视力、VEGF和PDGF,记录术后并发症和治疗成功率。结果 32例患者随访(8.57±1.69)个月,小梁切除术后1周、1个月、3个月、6个月眼压显著低于注药前,差异具有统计学意义(P<0.05);术后末次随访视力较注药前显著提高(P<0.05),视力提高率90.63%;患者注药后5 d和小梁切除术后1周、1个月、3个月、6个月房水、玻璃体液的VEGF和PDGF水平较注药前显著降低,差异具有统计学意义(P<0.05);小梁切除术后前房出血率6.25%,包裹性滤过泡率6.25%,脉络膜脱落率3.13%;术后6个月手术成功率93.75%。结论雷珠单抗玻璃体腔注射辅助用于小梁切除术和全视网膜光凝治疗,可显著降低NVG患者VEGF和PDGF水平,降低眼压、提高视力,安全有效。

Objective To study the effect of intravitreal injection of ranibizumab assisted microsurgery on the contents of vascular endothelial growth factors （VEGF）and platelet-derived growth factors （PDGF）in patients with neovascular glaucoma （NVG）. Methods The data of 32 patients （32 eyes） with NVG in our hospital were analyzed retrospectively. All the patients were treated with intravitreal injection of ranibizumab, trabeculectomy and panrentinal photocoagulation. The intraocular pressure （IOP） , visual acuity, VEGF and PDGF were compared before and after treatment. The postoperative complications and success rate of treatment were recorded. Results All 32 patients were followed up for （ 8.57 ± 1.69 ） months. 1 week, 1 month, 3 months and 6 months after trabeculectomy, IOP was significantly lower than that before the injection （P 〈 0. 05 ）. At the end of follow-up, the visual acuity was significantly better than that before injection（P 〈 0. 05 ）, and improvement rate of visual acuity was 90. 63%. 5 d after injection, 1 week, 1 month, 3 months and 6 months after trabeculectomy, the levels of VEGF and PDGF in aqueous humor and vitreous humor were significantly lower than those before injection （ P 〈 0. 05 ）. The rate of anterior chamber hemorrhage after trabeculectomy was 6.25 % , the rate of encapsulated fihering bleb was 6.25 % , and the rate of ehoroidal detachment was 3. 13%. The success rate of surgery was 93.75% at 6 months after surgery. Conclusion The application of intravitreal injection of ranibizumab in trabeculectomy and panrentinal photocoagulation can significantly reduce thelevels of VEGF and PDGF in patients with NVG, reduce IOP and improve visual acuity, safe and effective.