视网膜分支静脉阻塞继发黄斑水肿玻璃体注射雷珠单抗不同治疗方案的疗效对比

Comparison of different treatment regimens of macular edema secondary to branch retinal vein occlusion with intravitreal injection of ranibizumab

目的比较视网膜分支静脉阻塞继发黄斑水肿(macular edema secondary to branch retinal vein occlusion,BRVO-ME)玻璃体注射雷珠单抗(intravitreal injection of ranibizumab,IVR)1+PRN与3+PRN方案的疗效及安全性。设计回顾性病例系列。研究对象2016年1月至2018年3月天津爱尔眼科医院接受IVR的70例BRVO-ME患者。方法患者分为两组,注射1次后按需治疗者为1+PRN组;每月1次连续注射3个月后按需治疗者为3+PRN组。观察两组治疗前后最佳矫正视力(BCVA)、中央视网膜厚度(central retinal thickness,CRT)、中央脉络膜厚度(central choroid thickness,CCT)变化及并发症情况。主要指标BCVA、CRT、CCT。结果观察12个月时,1+PRN组BCVA较基线提高了(0.42±0.42)(P<0.05),CRT较基线降低了(385.96±344.23)μm(P<0.05),CCT较基线降低了(13.03±54.46)μm(P>0.05)。3+PRN组BCVA较基线提高了(0.43±0.39)(P<0.05),CRT较基线降低了(524.74±339.20)μm(P<0.05),CCT较基线降低了(5.00±28.04)μm(P>0.05)。两组间BCVA、CRT、CCT变化无统计学差异(P均>0.05)。观察期内1+PRN组平均IVR注射(3.50±0.99)次,3+PRN组(4.25±0.73)次(P<0.05)。结论IVR 1+PRN及3+PRN两种方案对BRVO-ME短期疗效显著,安全性较好;两种治疗方案对于短期内提高BCVA、减轻ME疗效相似,但1+PRN组需要注射的次数低于3+PRN组。BRVO-ME患者两种方案治疗前后CCT无明显变化。

Objective To compare the clinical efficacy and safety of IVR regimens of 1+PRN and 3+PRN for macular edema secondary to branch retinal vein occlusion(BRVO-ME).Design Retrospective case series.Participants 70 cases of BRVO-ME received intravitreal injection of ranibizumab from January 2016 to March 2018 in Tianjin Aier Eye Hospital.Methods All patients were divided into 1+PRN group and 3+PRN group according to the treatment regimen.Patients receiving PRN after one injection were classified to 1+PRN group,and patients receiving PRN after three months of continuous injection were classified to 3+PRN group.The mean LogMAR BCVA,central retinal thickness(CRT)and central choroid thickness(CCT)of the two groups of patients as well as complications during the follow-up were observed.Main Outcome Measures BCVA,CRT,CCT.Results At the end point of observation(12 months),BCVA increased by 0.42±0.42(P<0.05),CRT decreased by(385.96±344.23)μm(P<0.05),CCT decreased by(13.03±54.46)μm(P>0.05)compared with the baseline in the 1+PRN group.BCVA increased by 0.43±0.39(P<0.05),CRT decreased by(524.74±339.20)μm(P<0.05),CCT decreased(5.00±28.04)μm(P>0.05)compared with the baseline in the 3+PRN group.There was no significant difference between the two groups in variation of BCVA,CRT and CCT(all P>0.05).During the observation period,the average IVR injection times of the 1+PRN group were(3.50±0.99)times,and the IVR times of the 3+PRN group were(4.25±0.73)times(P<0.05).Conclusions Both IVR treatment regimen of 1+PRN and 3+PRN have significant short-term efficacy and good safety for BRVO-ME.The 1+PRN group achieved similar visual outcomes,reducing CRT and reducing macular edema for BRVO-ME with fewer injections compared with the 3+PRN group.Both treatments had no significant effect on the CCT of BRVO-ME patients before and after treatment.