玻璃体腔注射曲安奈德联合玻璃体切割术治疗特发性黄斑前膜的疗效及其对血清VEGF、HIF-1α水平的影响

Efficacy of vitreous chamber injective triamcinolone acetonide combined with vitrectomy in the treatment of idiopathic macular epiretinal membrane and its influence on serum VEGF and HIF-1αlevels

目的:探究玻璃体腔注射曲安奈德(TA)联合玻璃体切割术(PPV)治疗特发性黄斑前膜(IMEM)的效果。方法:按治疗方案不同将110例IMEM患者分为对照组(PPV治疗)和观察组(玻璃体腔注射TA联合PPV治疗),每组各55例。比较两组临床疗效及术眼最佳矫正视力(BCVA)、黄斑中心凹视网膜厚度(CMT)、黄斑中心凹内异位层(EIFL)+外丛状层厚度和血清血管内皮生长因子(VEGF)、低氧诱导因子(HIF-1α)水平。结果:术后1、3个月,观察组BCVA、CMT、EIFL+外丛状层厚度及血清VEGF、HIF-1α水平均低于对照组(P<0.05)。观察组术后并发症总发生率为9.09%,低于对照组的23.64%(P<0.05)。结论:玻璃体腔注射TA联合PPV治疗IMEM的疗效较显著,可明显提高患者术眼视力,促进黄斑解剖结构恢复,降低血清VEGF、HIF-1α水平,并可降低术后并发症发生率。

Objective:To investigate the effect of vitreous chamber injective triamcinolone acetonide(TA)combined with vitrectomy(PPV)in the treatment of idiopathic macular epiretinal membrane(IMEM).Methods:A total of 110 patients with IMEM were selected as the research objects and divided into control group(PPV treatment)and observation group(intravitreal injection of TA combined with PPV treatment)according to different treatment schemes,with 55 cases in each group.The clinical efficacy,best corrected visual acuity(BCVA),central macular thickness(CMT),ectopic inner foveal layer(EIFL)+outer plexiform layer thickness,serum vascular endothelial growth factor(VEGF)and hypoxia inducible factor-1α(HIF-1α)levels were compared between the two groups.Results:The BCVA,CMT,EIFL+outer plexiform thickness,serum VEGF and HIF-1αlevels of the observation group at 1 and 3 months after operation were lower than those of the control group(P<0.05).The total incidence of postoperative complications in the observation group was 9.09%,which was lower than 23.64%in the control group(P<0.05).Conclusion:Intravitreal injection of TA combined with PPV is effective in the treatment of IMEM,which can significantly improve the visual acuity of patients,promote the recovery of macular anatomical structure,reduce the levels of serum VEGF and HIF-1α,and reduce the incidence of postoperative complications.