阿柏西普联合23G玻璃体切割术治疗老年黄斑变性玻璃体积血

Aflibercept combined with 23G vitrectomy on patients with vitreous hemorrhage in senile macular degeneration

目的:探究阿柏西普玻璃体腔内注射(IAI)联合23G玻璃体切割术(VIT)治疗年龄>60岁老年黄斑变性玻璃体积血患者的效果。方法:选取78例(78眼)黄斑变性玻璃体积血患者,按照随机数字表法将其分成对照组和研究组,每组39例。对照组接受23G VIT治疗,研究组接受IAI联合23G VIT治疗。比较两组治疗前后黄斑中心凹厚度(cRMT),最佳矫正视力(BCVA),视网膜中央动脉(CRA)收缩期阻力指数(RI)、峰值流速(PSV)、舒张末期血流速度(EDV),丙二醇(MDA),脂质过氧化氢(LHP),活性氧(ROS),血管内皮生长因子(VEGF),碱性成纤维细胞生长因子(bFGF)水平及并发症发生率。结果:治疗5个月后,研究组cRMT、RI、MDA、LHP、ROS、VEGF、bFGF水平均较对照组低,而BCVA、PSV、EDV均较对照组高,差异有统计学意义(P<0.05);研究组并发症发生率2.56%,低于对照组20.51%(P<0.05)。结论:IAI辅助治疗年龄>60岁黄斑变性玻璃体积血患者可提高治疗效果,改善视网膜微循环。

Objective: To investigate the effects of intravitreal aflibercept injection(IAI) combined with 23 G vitrectomy(VIT) on patients aged over sixty with vitreous hemorrhage in senile macular degeneration. Methods: A total of 78 patients(78 eyes) with vitreous hemorrhage in macular degeneration were randomized into the control group, and the differences were statistically significant and study group, each with 39 cases. The control group received 23 G VIT therapy, while the study group received IAI combined with 23 G VIT therapy. Then, the foveal thickness(cRMT), best corrected visual acuity(BCVA), systolic resistance index(RI) of central retinal artery(CRA), peak flow velocity(PSV), end-diastolic blood flow velocity(EDV), malondialdehyde(MDA), lipid hydroperoxide(LHP), reactive oxygen species(ROS), vascular endothelial growth factor(VEGF), basic fibroblast growth factor(bFGF) level, and complication rates were compared between both groups. Results: After 5 months of treatment, the levels of cRMT, RI, MDA, LHP, ROS, VEGF and bFGF in the study group were lower than those in the control group, and BCVA, PSV and EDV were statistically higher than those in the control group(P< 0.05), and the total incidence of complications in the study group was 2.56%, which was lower than 20.51% in the control group(P<0.05). Conclusion: IAI adjuvant therapy for patients aged over 60 with vitreous hemorrhage in macular degeneration can effectively improve the efficacy and retinal microcirculation in patients.