玻璃体腔注射康柏西普联合黄斑区格栅样光凝治疗视网膜分支静脉阻塞继发黄斑水肿的疗效观察

Clinical observation of intravitreal in jection conbercept combined with macular grid photocoagulation for macnlar edema secondary to branch retinal vein occlusion

目的观察玻璃体腔注射康柏西普（intravitreal conbercept，IVC）联合黄斑区格栅样光凝治疗视网膜分支静脉阻塞（BRV0）继发黄斑水肿的疗效。方法将2016年1～12月在我院临床检查确诊的BRVO继发黄斑水肿患者27例（27只眼）纳入研究。所有患者均行最佳矫正视力（BCVA）、裂隙灯显微镜联合前置镜、眼压、光相干断层扫描、荧光素服底血管造影检查。依据就诊顺序按照随机排列表方法随机将患者分为治疗组：IVC＋激光联合治疗，对照组：单纯激光治疗，分别为14和13只眼。治疗组：玻璃体腔内注入康柏西普0．05ml，7d后行黄斑区格栅样光凝治疗。对比观察2组间治疗后1周，2周，1、3个月患眼BCVA和黄斑中心视网膜厚度（CMT）的变化情况。结果治疗后1周，2周，1、3个月，2组间BCVA提高及稳定眼数比较，差异均有统计学意义（x^2=7．052、5．342、6．454、4．492，P〈0．05），治疗组BCVA提高及稳定眼数明显多于对照组；2组间不同观察时间点平均CMT比较，差异均有统计学意义（t=12．713、15．178、15．690、14．578，P〈0．05），治疗组治疗后不同观察时间点平均CMT均较对照组降低。结论IVC联合黄斑区格栅样光凝治疗BRVO继发黄斑水肿的疗效优于单纯光凝治疗。

Objective To observe the efficacy of intravitreal conbercept （IVC） injection combined with macular grid laser photocoagulation for the treatment of macular edema secondary to branch retinal vein occlusion（BRVO）. Methods 27 patients（27 eyes）with macular edema secondary to BRVO diagnosed by clinical examination in our hospital from January to December 2016 were included. The best-corrected visual acuity （BCVA）, slit lamp microscope, intraocular pressure, optical coherence tomography and fundus fluorescein angiography were performed in all patients. The patients were randomly divided into treatment group （ 14 eyes, ） ： IVC -1- laser therapy, control, group （ 13 eyes, ） ： laser therapy alone. Treatment group ： IVC 0.05 ml, macular grid laser photocoagulation after 7 days. BCVA changes and macular fovea thickness （CMT）in 1 week,2 weeks, 1 month and 3 months after treatment were compared between the two groups. Results After treatment,1 week,2 weeks,1 month,3 months,2 groups of BCVA increased and stable eye number compared, the difference was statistically significant（x^2 = 7.052,5. 342,6. 454,4. 492, P〈0.05）, the treatment group BCVA increased and stabilize the number of eyes significantly more than the control group; The CMT of different observation time points （t = 12. 713, 15. 178, 15. 690, 14. 578, P 〈 0. 05）in the treatment group was lower than that in the control group. Conclusion The effect of IVC combined with macular grid laser photocoagulationt of macular edema secondary to BRVO is better than that of laser photocoagulation alone.