玻璃体腔注射雷珠单抗联合视网膜激光光凝对视网膜静脉阻塞黄斑水肿的疗效及对脉络膜厚度和炎症因子的影响

Effect of intravitreal ranibizumab injection combined with laser photocoagulation on macular edema with retinal vein occlusion and its effect on choroidal thickness and inflammatory factors

目的:探究玻璃体腔注射雷珠单抗联合视网膜激光光凝对视网膜静脉阻塞(retinal vein occlusion,RVO)继发黄斑水肿(macular edema,ME)的疗效及对脉络膜厚度、炎症因子的影响。方法:选取2019年1月至2021年12月绵阳市第三人民医院收治的120例RVO-ME患者为研究对象,按乱数表法随机分为对照组与观察组,各60例。对照组予以视网膜激光光凝治疗,观察组予以玻璃体腔注射雷珠单抗联合视网膜激光光凝治疗。比较2组治疗前及治疗3、6个月时最佳矫正视力(best corrected visual acuity,BCVA)、黄斑区水肿容积、黄斑中心凹下脉络膜厚度(subfoveal choroidal thickness,SFCT)、房水中炎症因子[白细胞介素-6(interleukin-6,IL-6)、IL-8]水平;并比较2组并发症的发生情况。结果:观察组治疗3、6个月时的BCVA均明显优于对照组(均P<0.05)。观察组治疗3、6个月时的黄斑区水肿容积、SFCT及房水中IL-6、IL-8水平均明显低于对照组(均P<0.05)。2组并发症总发生率比较差异无统计学意义(分别为3.33%和1.67%,P>0.05)。结论:玻璃体腔注射雷珠单抗联合视网膜激光光凝可有效提高RVO-ME患者视力,缓解水肿症状,改善脉络膜厚度,降低房水中的炎症因子水平。

Objective:To investigate the efficacy of intravitreal ranibizumab injection combined with laser photocoagulation on macular edema(ME)secondary to retinal vein occlusion(RVO)and its effect on choroidal thickness and inflammatory factors.Methods:A total of 120 RVO-ME patients admitted to Mianyang Third People’s Hospital from January 2019 to December 2021 were selected and randomly divided into a control group and an observation group according to the random number table method,with 60 cases in each group.The control group was treated with retinal laser photocoagulation,and the observation group was treated with intravitreal injection of ranibizumab combined with retinal laser photocoagulation.The best corrected visual acuity(BCVA),macular edema volume,subfoveal choroidal thickness(SFCT),and levels of inflammatory factors in aqueous humor[interleukin-6(IL-6)and IL-8]before treatment and 3 and 6 months after treatment were compared between the 2 groups;and the incidence of complications was compared between the 2 groups.Results:The BCVA of the observation group at 3 and 6 months of treatment was significantly better than those of the control group(both P<0.05).The macular edema volume,SFCT,IL-6,and IL-8 levels in aqueous humor in the observation group at 3 and 6 months after treatment were significantly lower than those in the control group(all P<0.05).There was no significant difference in the total incidence of complications between the 2 groups(3.33%vs 1.67%,P>0.05).Conclusion:Intravitreal injection of ranibizumab combined with retinal laser photocoagulation can effectively improve the visual acuity of RVO-ME patients,relieve edema symptoms,improve choroidal thickness,and reduce the levels of inflammatory factors in aqueous humor.