雷珠单抗联合地塞米松玻璃体内植入物对视网膜分支静脉阻塞合并黄斑水肿患者的疗效

Efficacy of ranibizumab combined with dexamethasone intravitreal implant in patients with branch retinal vein occlusion and macular edema

目的探究雷珠单抗联合地塞米松玻璃体内植入物对视网膜分支静脉阻塞合并黄斑水肿(BRVO-ME)患者血管内皮细胞生长因子(VEGFs)、白细胞介素(ILs)及临床疗效的影响。方法选取2021年6月至2023年6月就诊于新疆维吾尔自治区人民医院眼科的BRVO-ME患者74例74眼作为研究对象,随机化分为单抗治疗组(n=37)和联合治疗组(n=37):单抗治疗组给予雷珠单抗及生理盐水玻璃体腔内注射治疗,联合治疗组应用雷珠单抗联合地塞米松玻璃体内植入物玻璃体腔内注射治疗。对比两组患者治疗前及治疗3、6个月后眼科专科指标[眼压(IOP)、黄斑中心凹视网膜厚度(CMT)]、最佳矫正视力(BCVA)、前房水VEGFs(VEGF-A、VEGF-B)、前房水ILs(IL-6、IL-8)水平及不良事件的发生率。结果治疗3、6个月联合治疗组患者平均CMT、BCVA、前房水VEGF-A、IL-6、IL-8水平均显著低于治疗前和单抗治疗组(P<0.05);IOP、前房水VEGF-B水平在组间差异无统计学意义(P>0.05);两组患者不良事件发生率差异无统计学意义(P>0.05)。结论相比于单独应用雷珠单抗,地塞米松玻璃体内植入物联合雷珠单抗治疗方案能够更显著地改善BRVO-ME患者视觉质量,同时降低房水中炎症因子水平。

Objective To investigate the effects of ranibizumab combined with dexamethasone intravitreal implant on vascular endothelial growth factors(VEGFs),interleukins(ILs),and clinical efficacy in patients with branch retinal vein occlusion and macular edema(BRVO-ME).Methods Seventy-four patients(74 eyes)diagnosed with BRVO-ME at the Department of Ophthalmology,People′s Hospital of Xinjiang Uygur Autonomous Region,from June 2021 to June 2023 were selected for this study.The patients were randomly divided into the monoclonal treatment group(n=37)and the combination treatment group(n=37).The monoclonal treatment group received ranibizumab and saline intravitreal injections,while the combination treatment group received ranibizumab combined with dexamethasone intravitreal implant injections.Ophthalmologic indices[intraocular pressure(IOP),central macular thickness(CMT)],best-corrected visual acuity(BCVA),anterior chamber VEGFs(VEGF-A,VEGF-B),anterior chamber ILs(IL-6,IL-8)levels,and adverse events were compared before treatment and at 3 and 6 months after treatment.Results At 3 and 6 months post-treatment,the combination treatment group showed significantly lower mean CMT,BCVA,VEGF-A,IL-6,and IL-8 levels compared to before treatment and the monoclonal treatment group(P<0.05).There were no statistically significant differences in IOP and VEGF-B levels between the groups(P>0.05).The incidence of adverse events did not differ significantly between the two groups(P>0.05).Conclusion Compared to ranibizumab alone,the combination of dexamethasone intravitreal implant with ranibizumab significantly improves visual quality and reduces inflammatory cytokine levels in aqueous humor in patients with BRVO-ME.