雷珠单抗治疗慢性中心性浆液性脉络膜视网膜病变的临床效果观察

Clinical observation of ranibizumab in the treatment of chronic central serous chorioretinopathy

目的观察雷珠单抗治疗慢性中心性浆液性脉络膜视网膜病变(CSC)的临床效果。方法选取2016年3月至2017年3月在焦作煤业集团中央医院眼科经眼底照相、FFA及OCT检查确诊的16例(16眼)慢性CSC患者。所有患眼玻璃体腔均接受注射0. 5 mg/0. 05 ml雷珠单抗注射液治疗。第1次注射后每个月随访1次,根据随访情况决定是否重复治疗。患眼平均注射次数(2. 28±0. 32)次,随访6个月,16例均完成整个随访。采用标准对数视力表检查最佳矫正视力(BCVA),OCT测量黄斑中心凹区视网膜厚度(MCFT),对比治疗前后患眼BCVA、MCFT值,观察不良反应发生情况。结果治疗后1、3、6个月,患眼BCVA较治疗前提高,MCFT较治疗前降低,差异有统计学意义(P <0. 05)。注射后2眼出现眼压升高,治疗后1周恢复正常。随访期间未见青光眼、眼内炎等眼部并发症和全身不良反应发生。结论对玻璃体腔采用雷珠单抗注射治疗,可提高慢性CSC患眼视力,降低MCFT。

Objective To observe the clinical effect of vitreous injection of ranibizumab in the treatment of chronic central serous chorioretinopathy(CSC).Methods Sixteen patients(16 eyes)diagnosed as chronic CSC by fundus photography,fundus fluorescein angiography(FFA)and optical coherence tomography(OCT)were selected in Department of Ophthalmology,Jiao Zuo Mei Ye Ji Tuan Central Hospital from March of 2016 to March of 2017.The vitreous cavities of all affected eyes were treated with 0.5 mg/0.05 ml ranibizumab injection.After the first injection,patients were followed up once every month,and decided whether to repeat treatment based on the clinical effect.Patients were followed up for 6 months and the average number of injections was(2.28±0.32)times.Sixteen cases all finished the whole follow-up.Best corrected visual acuity(BCVA)and macular central foveal thickness(MCFT)were respectively measured by standard logarithmic visual acuity chart and OCT.BCVA and MCFT values of affected eyes before and after treatment were compared and the adverse reactions were observed.Results The BCVA values of affected eyes all increased at 1,3,6 months after treatment than those before treatment,and the MCFT values of affected eyes were lower than those before treatment,and the differences were statistically significant(P<0.05).Two eyes occured increased intraocular pressure after injection,and returned to normal one week after treatment.No ocular complications such as glaucoma or endophthalmitis and systemic adverse reactions occurred during the follow-up period.Conclusion The treatment of vitreous cavity with ranibizumab injection could improve the visual acuity of affected eyes of chronic CSC and decrease the MCFT of affected eyes.