雷珠单抗联合黄斑区格栅光凝治疗视网膜静脉阻塞继发黄斑水肿的效果观察

Effect observation of ranibizumab combined with macular grid laser photocoagulation on macular edema secondary to retinal vein occlusion

目的观察雷珠单抗联合黄斑区格栅光凝治疗视网膜静脉阻塞(RVO)继发黄斑水肿(ME的疗效。方法59例(59眼)视网膜静脉阻塞继发黄斑水肿患者,随机分为治疗组(30例,30眼)和对照组(29例,29眼)。对照组给予雷珠单抗治疗,治疗组给予雷珠单抗联合黄斑区格栅光凝治疗。比较两组患者治疗前后标准对数视力表(LogMAR)最佳矫正视力(BCVA)、黄斑中心凹厚度(CMT)及治疗6个月内雷珠单抗注射次数。结果治疗前及治疗1周、1个月、2个月,两组LogMAR BCVA比较,差异无统计学意义(P>0.05);治疗1周及1、2、6个月,两组LogMAR BCVA均低于治疗前,差异有统计学意义(P<0.05);治疗6个月,治疗组LogMAR BCVA(0.44±0.31)低于对照组的(0.80±0.10),差异有统计学意义(P<0.05)。治疗前及治疗1周、1个月、2个月,两组MCT比较,差异无统计学意义(P>0.05);治疗1周及1、2、6个月,两组MCT均低于治疗前,差异有统计学意义(P<0.05);治疗6个月,治疗组MCT(227.17±114.26)μm低于对照组的(358.00±171.00)μm,差异有统计学意义(P<0.05)。治疗组治疗6个月内雷珠单抗注射次数为(2.60±0.73)次,少于对照组的(3.07±0.80)次,差异有统计学意义(P<0.05)。结论雷珠单抗联合黄斑区格栅光凝治疗视网膜静脉阻塞继发黄斑水肿可逐步提高视力,减轻黄斑水肿,两者联合治疗更能减少就诊次数,减轻患者经济负担。

Objective To observe the efficacy of ranibizumab combined with macular grid laser photocoagulation on macular edema(ME)secondary to retinal vein occlusion(RVO).Methods A total of 59 patients(59 eyes)with macular edema secondary to retinal vein occlusion were randomly divided into a treatment group(30 patients,30 eyes)and a control group(29 patients,29 eyes).The control group was treated with ranibizumab,and the treatment group was treated with ranibizumab and macular grid laser photocoagulation.Both groups were compared in terms of standard Logarithmic visual acuity chart(LogMAR)best corrected visual acuity(BCVA),central macular thickness(CMT)before and after treatment,and the number of ranibizumab injections within 6 months of treatment.Results Before treatment and at 1 week,1 month and 2 months of treatment,there was no statistically significant difference in LogMAR BCVA between the two groups(P>0.05).At 1 week,1 month,2 months and 6 months of treatment,the LogMAR BCVA in both groups was lower than that before treatment,and the difference was statistically significant(P<0.05).At 6 months of treatment,the LogMAR BCVA(0.44±0.31)in the treatment group was lower than(0.80±0.10)in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in MCT between the two groups before treatment and at 1 week,1 month and 2 months of treatment(P>0.05).At 1 week,1 month,2 months and 6 months of treatment,the MCT in both groups was lower than that before treatment,and the difference was statistically significant(P<0.05).At 6 months of treatment,the MCT(227.17±114.26)μm in the treatment group was lower than(358.00±171.00)μm in the control group,and the difference was statistically significant(P<0.05).The number of ranibizumab injections within 6 months of treatment in the treatment group was(2.60±0.73)injections,which was less than(3.07±0.80)injections in the control group,and the difference was statistically significant(P<0.05).Conclusion Ranibizumab combined with macular grid laser photocoagulation can gradually improve visual acuity and reduce macular edema,and the combination of the two treatments can reduce the number of visits and the financial burden of patients.