增生性糖尿病视网膜病变玻璃体切除术后复发玻璃体积血的治疗探讨

Investigation of treatment of recurrent vitreous hemorrhage after vitrectomy for proliferative diabetic retinopathy

目的探讨增生性糖尿病视网膜病变(PDR)玻璃体切除术后复发玻璃体积血行抗血管内皮生长因子类药物(抗VEGF)玻璃体腔注射术的疗效。方法回顾性分析2016年9月至2018年1月,PDR玻切术后复发玻璃体积血15例(15只眼)的临床资料。所有患者均行雷珠单抗或康柏西普玻璃体腔注射术,并随访观察至注药后3个月。结果术后末次随访LogMAR视力为1.00±0.70,较术前的1.88±0.54有所提高(t=3.763,P=0.002)。玻璃体积血平均吸收时间(25.53±13.52)d,随访期间未见明显并发症。结论PDR患者玻切术后复发玻璃体积血给予玻璃体内抗VEGF药物注射可促进积血吸收,提高视力。

Objective To investigate the efficacy of intravitreal injection of anti-vascular endothelial growth factor ( anti-VEGF) drugs for recurrent vitreous hemorrhage after vitrectomy in patients with proliferative diabetic retinopathy ( PDR). Methods The data of 15 eyes of 15 PDR cases with recurrent vitreous hemorrhage after vitrectomy from Sep. 2016 to Jan. 2018 were analyzed retrospectively. All cases were treated with intravitreal injection of Ranibizumab or Conbercept. The followed up time was 3 months after injection. Results The visual acuity (logMAR) at the last follow-up improved to 1.00 ±0. 70 and was better than the preoperative visual acuity (1.88 ±0. 54)(Z = 3. 763 , P =0. 002). The mean absorption time of vitreous hemorrhage was (25. 53 ± 13. 52) days. No obvious complication was observed during the followup. Conclusion Intravitreal injection of anti-VEGF drugs for the treatment of postvitrectomy diabetic vitreous hemonhage can promote absorption of hemorrhage and improve visual acuity.