抗VEGF药物对不同年龄视网膜中央静脉阻塞继发黄斑水肿的疗效分析

Therapeutic effects of anti-VEGF drugs on patients with macular edema secondary to central retinal vein occlusion in different age groups

目的:分析抗血管内皮生长因子(VEGF)药物对不同年龄视网膜中央静脉阻塞继发黄斑水肿(CRVO-ME)患者的疗效。方法:回顾性选取2017-02/2019-03我院眼科收治的CRVO-ME患者102例102眼,均接受玻璃体腔注射雷珠单抗治疗,依据患者年龄将其分为CM1组(年龄<50岁,50例50眼)、CM2组(年龄≥50岁,52例52眼)。治疗后连续随访12mo,观察两组患者最佳矫正视力(BCVA)、黄斑中心视网膜厚度(CMT)、眼压、平均注射次数、第1次注射间期,记录并发症情况。结果:治疗后两组患者BCVA均较治疗前改善,CMT均较治疗前变薄,且治疗后9、12mo CM1组BCVA、CMT均优于CM2组(P<0.001)。治疗后1、2、3mo两组患者眼压均高于治疗前(P<0.01),治疗后6、9mo两组眼压均较治疗后3mo下降(P<0.05),至12mo时两组眼压均与治疗前持平(P>0.05),且CM1组治疗后1、2、3mo眼压均低于CM2组(P<0.01)。CM1组平均注射次数(3.24±0.35次)较CM2组(2.38±0.26次)多,且CM1组第1次注射间期(1.75±0.19mo)较CM2组(4.13±0.42mo)短(均P<0.01))。随访期间两组均未出现白内障加重、视网膜脱离、眼内炎等严重并发症。结论:抗VEGF药物(雷珠单抗)治疗CRVO-ME可明显提高患者视力,降低CMT,注射后1mo即显著改善,且不会对眼压造成明显影响。相比于50岁以上患者,50岁以下患者应用雷珠单抗后1a内效果更好,视力提高及CMT变薄更明显,早期眼压波动小,第1次注射间期缩短。

AIM:To analyze the therapeutic effects of anti-vascular endothelial growth factor(VEGF)drugs on patients with macular edema secondary to central retinal vein occlusion(CRVO-ME)in different age groups.METHODS:The study retrospectively reviewed 102 patients(102 eyes)with CRVO-ME treated with intravitreal injection of ranibizumab in ophthalmology department of the hospital between February 2017 and March 2019.The subjects were divided into CM1 group(under 50 years old,50 cases,50 eyes)and CM2 group(50 years old or older,52 cases,52 eyes),and were followed up for 12mo after treatment.The best corrected visual acuity(BCVA),central macular thickness(CMT),intraocular pressure,average injection times,first injection interval,and complications were recorded.RESULTS:After treatment,the BCVA of both groups was improved,and the CMT decreased.Besides,CM1 group had better BCVA and CMT than CM2 group at 9mo and 12mo(P<0.001).At 1mo,2mo,and 3mo,the intraocular pressure of both groups was higher than that before treatment(P<0.01).The intraocular pressures of both groups was lower at 6mo and 9mo than at 3mo after treatment(P<0.05),which returned to the pre-treatment level at 12mo(P>0.05).Additionally,CM1 group had lower intraocular pressure than CM2 group at 1mo,2mo,and 3mo after treatment(P<0.01).The average injection times in CM1 group was(3.24±0.35),more than(2.38±0.26)in CM2 group,and the first injection interval(1.75±0.19mo)was shorter than(4.13±0.42mo)in CM2 group(P<0.01).No serious complications such as cataract aggravation,retinal detachment,and endophthalmitis were observed in the two groups during follow-up.CONCLUSION:The treatment with anti-VEGF drugs(ranibizumab)for CRVO-ME can significantly improve the patients’visual acuity,and reduce CMT.The condition can be significantly improved within 1mo after injection,without significant influence on intraocular pressure.Compared with patients over 50 years old,patients under 50 years old can obtain better results after treatment with ranibizumab,more significant improvement of visual acuity,significantly thinner CMT,smaller intraocular pressure fluctuations and shorter first injection interval.