雷珠单抗球内注射联合561nm黄激光格栅光凝治疗糖尿病视网膜病变黄斑水肿的临床观察

The clinical observation on the treatment of macular edema in diabetic retinopathy with the combination of the injection combined with 561nm yellow laser

目的探讨玻璃体腔注射雷珠单抗联合视网膜黄斑区格栅光凝治疗糖尿病视网膜病变黄斑水肿的的临床效果。方法选取糖尿病视网膜病变黄斑水肿患者45例(80只眼),按是否注射雷珠单抗分为2组。玻璃体腔注射雷珠单抗联合视网膜黄斑区格栅光凝治疗作为观察组,22例(38眼),单纯视网膜黄斑区格栅光凝治疗作为对照组,23例(42眼),观察并比较2组治疗前、治疗后1个月、3个月、6个月患者视力、黄斑区视网膜厚度、眼压及治疗后并发症。结果 2组患者治疗后有效率:治疗组治愈22眼,显效14眼,无效2眼,总有效率为94.73%;对照组治愈17眼,显效15眼,无效10眼,总有效率为76.19%;经统计学分析,总有效率差异有统计学意义(P<0.05),治疗组疗效好于对照组。治疗前视力比较,2组差异无统计学意义(P>0.05);与治疗前视力相比,2组治疗后视力均显著提高(均为P<0.05);治疗后视力组间比较,治疗组视力好于对照组(P<0.05)。治疗组和对照组治疗前黄斑区视网膜厚度分别为(430.692±33.1738)μm、(448.023±29.1203)μm,2组间差异无统计学意义(P>0.05);治疗后黄斑区视网膜厚度分别为(205.210±79.6152)μm、(296.577±90.658)μm,较治疗前均降低(均为P<0.05),且治疗组低于对照组(P<0.05)。结论相对于单纯激光光凝术,561nm黄激光格栅样光凝联合球内注药治疗DME更加安全有效,术后视力恢复更快,黄斑水肿吸收更好。

Objective To discuss the clinical efficacy of 561 nm yellow grid laser photocoagulation combined with intravitreal ranibizumab injection for diabetic retinopathy(DR)macular edema.Methods 45 patients(80 eyes)with DR macular edema in our hospital were chosen and divided into two groups,22cases(38eyes)received the 561nm yellow grid laser photocoagulation combined with intravitreal Ranibizumab jection(observation group),and 23cases(42eyes)received single 561nm yellow grid laser photocoagulation(control group),the postoperative fundus changes were observed by FFA and fundus photography,the visual acuity was checked,and the macular retinal thickness was detected by OCT.Results In the observation group,the edema was cured in 22eyes,effective in 14 eyes,ineffective in 2 eyes,the total effectiverate was 94.73%;In the control group,the edema was cured in17 eyes,effective in 15 eyes,ineffective in 10 eyes,the total effective rate was 76.19%;Statistical difference was found between two groups(P<0.05).There was no difference in preoperative visual acuity between two groups(P>0.05),the postoperative visual acuity in two groups all increased(all P<0.05),the observation group group was better than the control group(P<0.05).The pretherapy macular retinal thickness of two groups were(430.692±33.1738)μm and(448.023±29.1203)μm,which after post-treatment were(205.210±79.6152)μm and(296.577±90.658)μm.Statistical difference was found between two group in postoperative macular retinal thickness(P<0.05).Conclusion Compared with the single 561nm yellow grid laser photocoagulation,the 561nm yellow grid laser photocoagulation combined with intravitreal ranibizumab injection for DR macular edema is more effective and safe with better postoperative visual acuity recovery