眼底激光联合雷珠单抗治疗对糖尿病视网膜病变及静脉阻塞引起黄斑水肿患者视力的影响

Effects of fundus laser combined with leizumab on visual acuity in patients with diabetic retinopathy and macular edema caused by venous obstruction

目的探讨眼底激光联合雷珠单抗治疗对糖尿病视网膜病变及静脉阻塞引起黄斑水肿患者视力的影响。方法回顾性选取2021年1月至2022年1月哈尔滨医科大学附属第四医院糖尿病视网膜病变及静脉阻塞引起黄斑水肿患者120例,依据治疗方法分为眼底激光联合雷珠单抗治疗组(联合治疗组)和眼底激光单独治疗组(单独治疗组)两组,各60例。对比分析两组患者的临床疗效、症状改善时间、黄斑区视网膜厚度、黄斑中心凹厚度(CMT)、最佳矫正视力(BCVA)、眼压、视力改善情况、并发症发生情况和治疗满意度。结果联合治疗组患者的总有效率为86.67%,明显高于单独治疗组(63.33%),差异有统计学意义(P<0.05)。联合治疗组患者的眼底出血吸收时间、黄斑水肿改善时间和渗出吸收时间分别为(2.30±0.23)、(4.31±0.34)、(10.23±0.34)周,均明显短于单独治疗组[(3.18±0.34)、(5.67±0.41)、(12.15±1.46)周],差异均有统计学意义(P<0.05)。治疗后,两组患者的黄斑区视网膜厚度、CMT、眼压均明显低于治疗前,BCVA均明显高于治疗前,联合治疗组患者的黄斑区视网膜厚度、CMT、眼压分别为(242.63±20.23)μm、(247.04±23.14)μm、(13.28±0.93)mmHg,均明显低于单独治疗组[(281.52±24.75)μm、(352.53±29.35)μm、(15.23±1.15)mmHg],BCVA为0.81±0.13,明显高于单独治疗组(0.55±0.15),差异均有统计学意义(P<0.05)。联合治疗组患者的视力提高率高于单独治疗组,视力稳定率、视力降低率均明显低于单独治疗组,差异有统计学意义(P<0.05)。联合治疗组患者的并发症发生率为10.00%,明显低于单独治疗组(26.67%),治疗满意率为90.00%,明显高于单独治疗组(66.67%),差异有统计学意义(P<0.05)。结论糖尿病视网膜病变及静脉阻塞引起黄斑水肿治疗中眼底激光联合雷珠单抗治疗较眼底激光单独治疗更能缩短症状,改善时间,提高患者视力和治疗满意度,值得被推广应用。

Objective To investigate the effects of fundus laser combined with leizumab on visual acuity of patients with diabetic retinopathy and macular edema caused by venous obstruction.Methods From January 2021 to January 2022,120 patients with macular edema caused by diabetes retinopathy and venous occlusion in the Four Affiliated Hospital of Harbin Medical University were retrospectively selected.According to the treatment method,they were divided into two groups:fundus laser combined with Razumab treatment group(combined treatment group)and fundus laser alone treatment group(single treatment group),with 60 cases in each group.The clinical efficacy,symptom improvement time,macular retinal thickness,macular foveal thickness(CMT),best corrected visual acuity(BCVA),intraocular pressure,vision improvement,complications and treatment satisfaction of the two groups were compared and analyzed.Results The total effective rate of the combined treatment group was 86.67%,which was significantly higher than that of the single treatment group(63.33%),and the difference was statistically significant(P<0.05).After treatment,the retinal thickness,CMT and intraocular pressure in the macular region of the two groups were(2.30±0.23),(4.31±0.34)and(10.23±0.34)weeks,which were significantly shorter than those in the single treatment group[(3.18±0.34),(5.67±0.41)and(12.15±1.46)weeks],the differences were statistically significant(P<0.05).After treatment,the retinal thickness,CMT and intraocular pressure in the macular region of the two groups were significantly lower than those before treatment,and BCVA were significantly higher than those before treatment(P<0.05);the macular retinal thickness,CMT and IOP of patients in the combined treatment group were(242.63±20.23)μm,(247.04±23.14)μm,(13.28±0.93)mmHg,which were significantly lower than those in the treatment group alone[(281.52±24.75)μm,(352.53±29.35)μm,(15.23±1.15)mmHg],BCVA was 0.81±0.13,which was significantly higher than that of the single treatment group(0.55±0.15),and the differences were statistically significant(P<0.05).The visual acuity improvement rate of the combined treatment group was higher than that of the single treatment group,and the visual acuity stability rate and visual acuity reduction rate were significantly lower than those of the single treatment group,and the differences were statistically significant(P<0.05).The complication rate of the combined treatment group(10.00%)was significantly lower than that of the single treatment group(26.67%),the treatment satisfaction rate of patients in the combined treatment group was 90.00%,which was significantly higher than that in the single treatment group(66.67%),and the differences were statistically significant(P<0.05).Conclusion In the treatment of macular edema caused by diabetes retinopathy and venous occlusion,fundus laser combined with ranibizumab can shorten the time of symptom improvement,improve patients'vision and treatment satisfaction more than fundus laser alone,which is worth popularizing.