激光联合贝伐珠单抗玻璃体腔注射对放射性视网膜病变患者最佳矫正视力、眼压和黄斑中心凹厚度的影响

Effects of photocoagulation combined with intravitreal injection of bevacizumab on the best-corrected visual acuity,intraocular pressure and central macular thickness in patients with radiation retinopathy

目的分析激光联合贝伐珠单抗玻璃体腔注射对放射性视网膜病变患者最佳矫正视力、眼压和黄斑中心凹厚度的影响。方法选取65例(69只眼)放射性视网膜病变患者行前瞻性研究,随机分为对照组32例(34只眼)行激光治疗及研究组33例(35只眼)行激光联合贝伐珠单抗玻璃体腔注射治疗,比较两组治疗前后其最佳矫正视力、眼压和黄斑中心凹厚度的变化情况。结果对照组治疗前后的最佳矫正视力比较均无显著差异(P>0.05),而研究组治疗后3个月、9个月的最佳矫正视力均高于治疗前(P<0.05),且治疗后3个月、9个月时均优于对照组(P<0.05);两组治疗前后的眼压分别进行比较,均无显著差异(P>0.05);两组治疗后3个月、9个月的黄斑中心凹厚度均薄于治疗前(P<0.05),且研究组均优于对照组(P<0.05)。结论相比单一激光治疗,激光联合贝伐珠单抗玻璃体腔注射对放射性视网膜病变患者的近期疗效更为理想,能够明显改善患者视力,但其远期疗效如何仍需今后进一步探讨。

Objective To analyze the effects of photocoagulation combined with intravitreal injection of bevacizumab on the best-corrected visual acuity,intraocular pressure and central macular thickness in patients with radiation retinopathy.Methods 65 cases(69 eyes)of radiation retinopathy were selected in our hospital and divided into the control group with 32 cases(34 eyes)underwent photocoagulation therapy andthe study group with 33 cases(35 eyes)received photocoagulation combined with intravitreal injection of bevacizumab treatment,and the changes of best-corrected visual acuity,intraocular pressure and central macular thicknessbefore and after treatment were compared between the two groups.Results The best-corrected visual acuityin the control group showed no significant difference before and after treatment(P>0.05).The best-corrected visual acuity in the study group after treatment at 3,9 months were higher than those before treatment(P<0.05),and the best-corrected visual acuity in the study group at 3,9 months after treatment were better than that in the control group(P<0.05).The intraocular pressure between the two groups before and after treatment showed no significant difference(P>0.05).The central macular thickness in the two groups after treatment at 3,9 months were thinner than that before treatment(P<0.05)and those levels in the study group were better than those in the control group(P<0.05).Conclusion Compared with single photocoagulation therapy,photocoagulation combined with intravitreal injection of bevacizumab has better curative effects on patients with radiation retinopathy,which can obviously improve the vision,but the long-term efficacy of the treatment remains to be further explored.