抗VEGF治疗不同类型视网膜静脉阻塞继发黄斑水肿的效果

Efficacy of anti-VEGF therapy for the treatment of macular edema secondary to different types of retinal vein occlusion

目的评估不同类型视网膜静脉阻塞黄斑水肿(RVO-ME)行抗VEGF治疗的效果。方法回顾性病例对照研究。分析郑州大学第一附属医院2015年1月至2019年7月行玻璃体内注射VEGF者158例(158只眼)RVO-ME的临床资料。根据阻塞发生部位不同,分为分支静脉阻塞(BRVO)组102例,中央静脉阻塞(CRVO)组56例。收集所有患者注射前视力、末次注射后视力、注射次数、治疗后视力变化及生活质量变化的数据并进行统计学分析。结果CRVO组平均注射次数3.0(3.0,4.8)次,末次注射后视力为0.50(0.30,0.90);BRVO组平均注射次数3.0(3.0,4.0)次,末次注射后视力为0.40(0.25,0.60)。两组治疗后视力较治疗前均显著提高(均P<0.05)。BRVO组视力较CRVO组视力提高更明显,差异具有统计学意义(P<0.05)。两组接受注射次数差异无统计学意义(均P>0.05)。结论玻璃体内注射抗VEGF药物可提高各型视网膜静脉阻塞黄斑水肿患者视力,多数患者接受眼内注射次数≤3次,且BRVO者视力提高优于CRVO者。

Objective To evaluate the efficacy of anti-VEGF treatment for macular edema due to different type of retinal vein occlusion(RVO-ME).Methods This was a retrospective case control study.The clinical data of 158 eyes of 158 cases with RVO-ME received intravitreal injection of anti-VEGF drug from Jan.2015 to Jul.2019 in the First Affiliated Hospital of Zhengzhou University were analyzed.These patients were divided into 102 cases as the branch retinal vein occlusion(BRVO)group and 56 cases as the central retinal vein occlusion(CRVO)group,by the location of the disease.The visual acuity before and after treatment,injection numbers,the visual acuity change and the life quality change after stopping treatment were collected and statistically analyzed.Results The CRVO group recieved 3.0(3.0,4.8)injections in average,and the visual acuity after treatment increased to 0.50(0.30,0.90).The BRVO group recieved 3.0(3.0,4.0)injections in average,and the visual acuity after treatment increased to 0.40(0.25,0.60).The visual acuity after treatment in both groups were statistically better than that before treatment(all P<0.05).The visual acuity in the BRVO group improved more than that in the CRVO group after treatment(P<0.05).The difference of the number of injections between the two groups was not statistically significant(P>0.05).Conclusion Anti-VEGF treatment can increase the visual acuity of RVO-ME patients of different types.Majority of patients with RVO-ME can receive 3 times injections or less,and BRVO patients can obtain a better visual acuity than CRVO patients.