不同方法治疗视网膜分支静脉阻塞继发黄斑水肿的疗效比较

Comparison of therapeutic effect of different methods on treatment of macular edema secondary to branch retinal vein occlusion

目的探讨不同方法治疗视网膜分支静脉阻塞继发黄斑水肿的疗效。方法视网膜分支静脉阻塞继发黄斑水肿患者168例168眼随机分为三组,每组56例56眼。A组给予玻璃体腔注射康柏西普+黄斑区格栅样激光光凝治疗, B组给予玻璃体腔注射康柏西普治疗, C组给予黄斑区格栅样激光光凝治疗。治疗后1周、 1个月、 3个月及6个月时复查光学相干断层扫描和荧光素眼底血管造影,记录并比较三组治疗次数和治疗前后最佳矫正视力、黄斑中心凹视网膜厚度及并发症发生情况。结果 A组患眼玻璃体腔注射次数为(1.2±0.3)次, B组为(2.4±1.1)次, A组低于B组(P <0.05)。A组患眼接受激光能量为(95.8±3.6) eV, C组为(116.3±5.6) eV, A组低于C组(P <0.05)。与治疗前比较,三组治疗后最佳矫正视力均有提高,黄斑中心凹视网膜厚度均呈逐渐减小趋势。治疗后1周、 1个月、 3个月及6个月A组的最佳矫正视力均高于C组(P <0.05),黄斑中心凹视网膜厚度均小于C组(P <0.05); B组与其他两组比较均无显著差异(P> 0.05)。未见视网膜脱离、虹膜红变及眼内炎等并发症发生。结论玻璃体腔注射康柏西普联合黄斑区格栅样激光光凝治疗有利于提高视网膜分支静脉阻塞继发黄斑水肿的治疗效果,且临床安全性较高。

AIM To explore the efficacy of different methods in the treatment of macular edema secondary to branch retinal vein occlusion.METHODS One hundred and sixty-eight eyes of 168 patients with macular edema secondary to retinal branch vein occlusion were randomly divided into three groups,56 patients and 56 eyes in each group.The group A was given intravitreal injection of conbercept ＋ macular area laser-like photocoagulation treatment.The group B was given intravitreal injection of conbercept,and the group C was treated with macular area laser-like photocoagulation.At the first week,the first month,the third month,and the sixth month after treatment,optical coherence tomography and fluorescein fundus angiography were performed.The number of treatments and the best corrected visual acuity before and after treatment,and the foveal retinal thickness of the macula were recorded and compared.Complications were observed.RESULTS The number of intravitreal injections in the group A was（1.2 ± 0.3） times,and lower than that in the group B（（2.4 ± 1.1） times,P 0.05）.The average laser energy of the group A was（95.8 ± 3.6） eV,and lower than that in the group C（（116.3 ± 5.6） eV,P 0.05）.Compared with before treatment,the best corrected visual acuity was improved in all three groups,and the retinal thickness of the fovea was gradually reduced.The best corrected visual acuity of the group A was higher than that of the group C at the first week,the first month,the third month,and the sixth month after treatment（P 0.05）,and the retinal thickness of the fovea was smaller than that of the group C（P 0.05）.There was no significant difference between the group B and the other two groups（P 0.05）.No complications such as retinal detachment,iris reddening,and endophthalmitis occurred.CONCLUSION Intravitreal injection of conbercept combined with macular area laser-like photocoagulation is beneficial to improve the therapeutic effect of macular edema secondary to branch retinal vein occlusion,and has high clinical safety.