抗VEGF药物玻璃体腔注射治疗继发性黄斑水肿的疗效分析

Effect of anti-VEGF drug intravitreal injection on secondary macular edema

目的观察玻璃体腔注射抗VEGF药物治疗视网膜静脉阻塞(RVO)继发性黄斑水肿和糖尿病性黄斑水肿(ME)的疗效。方法选取2017年1月至2019年7月在本院诊断为RVO继发性黄斑水肿并采用康柏西普眼用注射液注射治疗的患者90例(90只患眼)作为RVO组。糖尿病性黄斑水肿患者65例(70只患眼)作为DR组。两组行康柏西普玻璃体腔注射并按需给予视网膜激光术治疗,治疗后进行随访,比较两组视力改善情况及黄斑水肿改善情况。结果RVO组视力提高47只眼(52.5%),视力不变39只眼(43.1%),视力下降4只眼(4.4%),OCT形态恢复正常50只眼(55.0%),改善26只眼(29.4%),无改善14只眼(15.6%)。DR组视力提高24只眼(34.0%),视力不变43只眼(62%),视力下降3只眼(4.2%)。OCT形态恢复正常23只眼(33.0%),改善21只眼(30.0%),无改善26只眼(37.0%)。两组视力提高占比比较差异有统计学意义(P<0.05)。两组OCT形态恢复正常及改善占比比较差异有统计学意义(P<0.05)。结论玻璃体腔注射抗VEGF药物治疗视网膜静脉阻塞(RVO)继发性黄斑水肿和糖尿病性黄斑水肿(ME)疗效显著,且治疗RVO疗效更佳。

Objective To observe the effect of intravitreal injection of anti-VEGF drugs on retinal vein occlusion(RVO)followed by macular edema and diabetic macular edema(ME).Methods 90 patients(90 eyes)who were diagnosed with RVO secondary macular edema in our hospital from January 2017 to July 2019 and were treated with Conbercept ophthalmic injection were selected as the RVO group.65 patients with diabetic macular edema(70 eyes)were served as the DR group.The two groups underwent intravitreal injection of conbercept and retinal laser treatment as needed.Follow-up was conducted after treatment to compare the improvement of vision and macular edema.Results 47 eyes(52.5%)were improved in the final follow-up RVO group,39 eyes(43.1%)in the same vision,4 eyes(4.4%)in the decreased vision OCT 50 eyes(55.0%)in the normal form,26 eyes(29.4%)in the improved group,and 14 eyes(15.6%)in themodified group.24 eyes(34.0%),43 eyes(62%)and 3 eyes(4.2%)were in DR group with visual acuity improvement.OCT morphology returned to normal in 23 eyes(33.0%),improved in 21 eyes(30.0%),and no improvement in 26 eyes(37.0%).The difference in the proportion of visual acuity improvement between the two groups was statistically significant(P<0.05).There was a statistically significant difference between the two groups of OCT morphology returning to normal and the proportion of improvement(P<0.05).Conclusion Anti VEGF drug is a safe and effective method for the treatment of macular edema secondary to retinal vein occlusion and diabetic retinopathy.