阿柏西普联合曲安奈德治疗视网膜中央静脉阻塞继发黄斑水肿的效果

Efficacy of aflibercept combined with triamcinolone acetonide for the treatment of macular edema secondary to central retinal vein occlusion

目的评价玻璃体内注射阿柏西普联合后部眼球筋膜下注射曲安奈德治疗视网膜中央静脉阻塞(CRVO)继发黄斑水肿的效果。方法回顾性分析郑州市第七人民医院2018年12月至2020年12月收治的CRVO继发黄斑水肿66例(66眼)的临床资料。将患者分为两组:阿柏西普组33例行阿柏西普玻璃体内注射;联合组33例行阿柏西普玻璃体内注射联合曲安奈德后部眼球筋膜下注射。观察两组治疗前后视力及黄斑中心区厚度。结果注射后1、3及6个月两组视力均优于治疗前(P<0.01)。注射后1个月,联合组视力优于阿柏西普组(t=2.18,P=0.033);联合组眼压较前升高,但仍在正常范围内。两组治疗后CMT均低于治疗前(P<0.05),联合组优于对照组(P<0.05)。结论后部眼球筋膜下注射曲安奈德联合玻璃体内注射阿柏西普治疗CRVO继发黄斑水肿效果优于单纯阿柏西普的治疗。

Objective To evaluate the efficacy of intravitreal injection of aflibercept combined with sub-Tenon’s capsule injection of triamcinolone acetonide for the treatment of the macular edema secondary to central retinal vein occlusion(CRVO).Methods The clinical data of 66 eyes of 66 patients with macular edema secondary to CRVO from Dec.2018 to Dec.2020 in the Seventh People’s Hospital of Zhengzhou were analyzed retrospectively.The patients were divided into two groups:aflibercept intravitreal injection in 33 cases of the aflibercept group;intravitreal injection of aflibercept combined with triamcinolone acetonide in 33 cases of the combined group.The visual acuity,intraocular pressure and central maculor thickness of the two groups were observed before and after treatment.Results At 1 month,3 months and 6 months after treatment,the visual acuity of the two groups were significantly better than that before treatment(P<0.01).After 1 month of injection,the BCVA(LogMAR)was 0.35±0.11 in the combined triamcinolone acetonide group,which was better than the 0.41±0.11 of aflibercept group(t=2.18,P=0.033).In the combined group,the average intraocular pressure increased at one month after treatment,but it was still within the normal range.The CMT of two groups after treatment were all lower than that before treatment(all P<0.05),that of the combined group was better than that of the control group(P<0.05).Conclusion Sub-Tenon’s capsule injection of triamcinolone acetonide combined with intravitreal injection of aflibercept is more effective for the treatment of macular edema secondary to CRVO than that of aflibercept alone,which can reduce retinal edema and improve vision.