光凝术联合雷珠单抗对BRVO继发ME的疗效

Therapeutic effect of photocoagulation combined with Ranibizumab on BRVO secondary ME

目的研究视网膜激光光凝术联合雷珠单抗对视网膜分支静脉阻塞(BRVO)继发黄斑水肿(ME)疗效及安全性影响。方法选取2013年10月-2016年10月在本院接受治疗的BRVO继发ME患者共300例(300眼),随机分为单一注射组150例(150眼),按照0.04 m L/0.4 mg标准给予患者注射雷珠单抗,每个月注射一次,一共注射3个月;联合治疗组150例(150眼),按照上面标准每月给患者注射一次雷珠单抗,并在第一次注射一周后对患者行格栅样视网膜激光光凝术(GLP)。结果经过治疗后两组患者黄斑中心凹厚度(CMT)均有下降、最佳矫正视力(BCVA)均有上升,联合治疗组效果优于单一注射组,差异均有统计学意义(P<0.05);荧光素眼底血管造影术(FFA)检测结果显示,联合治疗组患者在治疗3个月后血管渗漏现象明显改善,优于单一注射组,差异有统计学意义(P<0.05)。结论视网膜激光光凝术联合雷珠单抗可以降低BRVO-ME患者的CMT,改善其ME,视力得到提高,且治疗效果明显优于单一注射雷珠单抗者。

Objective To investigate the efficacy and safety of laser therapy combined with Ranibizumab in the treatment of branch retinal vein occlusion（BRVO）secondary to macular edema（ME）. Methods From October 2013 to October 2016 in our hospital,300 BRVO patients with ME secondary（300 eyes）were randomly divided into single injection group and combine treatment group,150 cases（150 eyes）each. Patients of single injection group were given Ranibizumab at 0.04 m L/0.4 mg,injected once a month for a total of 3 months. Patients of combined treatment group were injected monthly with Ranibizumab（same concentration as the single injection group）on a monthly basis and underwent grid-like retinal laser photocoagulation（GLP）one week after the first injection. Results After treatment,the central macular thickness（CMT）decreased and the best corrected visual acuity（BCVA）increased in both groups. The combined treatment group was superior to single injection group（P〈0.05）. Fluorescein fundus angiography（FFA）test results showed that the vascular leakage significantly improved in the combined treatment group after 3 months treatment,and was better than that of the single injection group（P〈0.05）.Conclusion Retinal laser photocoagulation combined with Ranibizumab can reduce CMT in patients with BRVO-ME,improve its ME,and improve visual acuity,and was significantly better than single injection of Ranibizumab.