雷珠单抗注射液联合577 nm阈值下微脉冲激光光凝对糖尿病黄斑水肿患者CMT及TMV的影响

Effect of Ranibizumab Injection Combined and 577nm Micropulse Laser Photocoagulation on CMT and TMV of Patients with Diabetic Macular Edema

目的观察应用雷珠单抗注射液联合577 nm阈值下微脉冲激光光凝对糖尿病黄斑水肿患者视网膜厚度(central macular thickness,CMT)及黄斑体积(total macular volume,TMV)的影响。方法选择2017年12月至2018年12月,糖尿病黄斑水肿患者72例72只眼,按随机数字表法分为研究组患者36例,给予雷珠单抗注射液联合577 nm阈值下微脉冲激光治疗;对照组患者36例,给予雷珠单抗注射液治疗。记录治疗后1、3、6及9个月雷珠单抗注射液的平均注射次数、两组患者黄斑中心凹下CMT、黄斑中心凹下脉络膜厚度(Subfoveal choroidal thickness,SFCT)、TMV、最佳矫正视力(best corrected vision acuity,BCVA)的变化情况。结果治疗后9个月,研究组和对照组雷珠单抗注射液平均注射次数分别为(1.41±0.3)次、(1.93±0.3)次,差异具有显著意义(P<0.05)。治疗前两组BCVA比较差异无统计学意义(P>0.05);治疗后9个月,两组BCVA均较治疗前升高,差异具有统计学意义(P<0.05);两组间BCVA比较,差异无统计学意义(P>0.05)。治疗前两组CMT比较差异无统计学意义(P>0.05);治疗后9个月,两组CMT均较治疗前下降,差异具有统计学意义(P<0.05);两组间CMT比较,差异无统计学意义(P>0.05)。治疗前两组TMV比较差异无统计学意义(P>0.05);治疗后9个月,两组TMV均较治疗前下降,差异具有统计学意义(P<0.05);两组间TMV比较,差异无统计学意义(P>0.05)。治疗前,两组SFCT比较差异无统计学意义(P>0.05);治疗后9个月,两组SFCT均较治疗前下降,差异具有统计学意义(P<0.05);两组间SFCT比较,差异具有统计学意义(P<0.05)。结论雷珠单抗注射液联合577 nm阈值下微脉冲激光光凝治疗可有效减少糖尿病黄斑水肿患者雷珠单抗注射液平均注射次数,减少黄斑中心凹视网膜厚度,缩小黄斑体积,值得临床推广使用。

Objective To observe the joint effect of ranibizumab injection and micropulse laser photocoagulation at a threshold of 577 nm on the CMT and TMV of patients with diabetic macular edema.Methods Totally 72 patients with 72 eyes diagnosed as diabetic macular edema from Dec.2017 to Dec.2018 were included in the study and divided randomly into two group:the study groups(36 patients given ranibizumab injection plus 577 nm micropulse laser treatment) and control group (36 patients given ranibizumab injection).The average number of ranibizumab injections after treatment,and the thickness of the macular fovea(central macular thickness,CMT),thickness of the choroid in the macular fovea(Subfoveal choroidal thickness,SFCT),macular volume(total macular volume,TMV) and best corrected visual acuity (best corrected vision,BCVA)3,6,and 12 months after the treatment were recorded respectively.Results One year after the treatment,the average times of ranibizumab injection in the study group and the control group were(1.41±0.3)and(1.93±0.3)respectively.The difference between the two groups was significant(P<0.05).Before the treatment,the difference in BCVA between the two groups was not statistically significant(P>0.05);after treatment,the BCVA of the two groups was higher than before treatment,the difference was statistically significant(P<0.05).The BCVA of both groups increased after the treatment,and the difference was statistically significant(P<0.05).There was no difference in BCVA between the two groups(P>0.05).Before the treatment,the difference in CMT between the two groups was not statistically significant(P>0.05).After the treatment,the CMT of both groups decreased,and the difference was statistically significant(P<0.05).There was no statistical difference in CMT between the two groups(P>0.05).Before the treatment,there was no statistically significant difference in TMV between the two groups (P>0.05).After the treatment,the TMV of both groups decreased,and the difference was statistically significant (P<0.05).There was no statistical difference in TMV between the two groups (P>0.05).Before the treatment,there was no statistically significant difference in SFCT between the two groups(P>0.05).After the treatment,the SFCT of both groups decreased,and the difference was statistically significant(P<0.05).The difference between the two groups in SFCT was statistically significant(P<0.05).Conclusions The combination of ranibizumab injection and 577 nm micropulse laser photocoagulation will effectively reduce the average number of ranibizumab injections in patients with diabetic macular edema while reducing macular fovea retina thickness and macula volume.It is worthy of clinical promotion.