雷珠单抗单次玻璃体腔注射联合激光治疗视网膜中央静脉阻塞继发黄斑水肿疗效观察

Efficacy of single intravitreal injection of Ranizumab combined with laser in the treatment of macular edema secondary to central retinal vein occlusion

目的观察雷珠单抗单次玻璃体腔注射联合激光治疗视网膜中央静脉阻塞(CRVO)继发黄斑水肿的临床疗效。方法选取2017年1月至2020年1月榆林市星元医院眼科收治的150例(150眼)CRVO继发黄斑水肿患者为研究对象,按简单随机数表法分为观察组和对照组各75例(75眼)。对照组患者给予激光治疗,观察组患者给予单次玻璃体腔注射雷珠单抗联合激光治疗。于治疗后1个月,比较两组患者临床疗效和并发症发生情况,并对比分析术前24 h、术后1个月、术后6个月、术后12个月两组患者的最佳矫正视力和黄斑中心凹厚度。结果观察组患者的治疗总有效率为93.33%,明显高于对照组的77.33%,差异有统计学意义(P<0.05);术后1个月、6个月、12个月,两组患者最佳矫正视力比较差异均无统计学意义(P>0.05);术后1个月、6个月、12个月,观察组患者的黄斑中心凹厚度分别为(340.27±22.65)μm、(264.21±14.52)μm、(234.51±9.38)μm,明显低于对照组的(438.64±33.72)μm、(375.57±26.21)μm、(316.57±16.44)μm,差异均有统计学意义(P<0.05);观察组和对照组患者的并发症发生率分别为9.33%、12.00%,差异无统计学意义(P>0.05)。结论雷珠单抗单次玻璃体腔注射联合激光治疗CRVO继发黄斑水肿可提高患者视力,减轻黄斑水肿程度,临床效果显著且安全性高。

Objective To observe the clinical efficacy of single intravitreal injection of Ranizumab combined with laser in the treatment of macular edema secondary to central retinal vein occlusion(CRVO).Methods A total of150 patients(150 eyes)with macular edema secondary to CRVO admitted to the Department of Ophthalmology,Yulin Xingyuan Hospital from January 2017 to January 2020 were selected as the research objects.They were randomly divided into the observation group and the control group,with 75 cases(75 eyes)in each group.The patients in the control group were given laser therapy,and the patients in the observation group were given a single intravitreal injection of Ranizumab combined with laser therapy.One month after treatment,the clinical efficacy and complications of the two groups were compared,and the best corrected visual acuity and foveal thickness of the two groups were compared at 24 hours before operation and 1 month,6 months,and 12 months after operation.Results The total effective rate of the observation group was 93.33%,which was significantly higher than 77.33%of the control group(P<0.05).There was no significant difference in best corrected visual acuity between the two groups at 1 month,6 months,and 12 months after surgery(P>0.05).The thickness of the fovea in the observation group was(340.27±22.65)μm,(264.21±14.52)μm,and(234.51±9.38)μm at 1 month,6 months,and 12 months after surgery,which were significantly smaller than(438.64±33.72)μm,(375.57±26.21)μm,(316.57±16.44)μm in the control group(P<0.05).The incidence of complications in the observation group and the control group were 9.33%and 12.00%,respectively,with no statistically significant difference(P>0.05).Conclusion Single intravitreal injection of Ranizumab combined with laser in the treatment of macular edema secondary to CRVO can improve the visual acuity and reduce the degree of macular edema,with significant clinical effect and high safety.