[1]梁沛,王谭,李东辉,等.视网膜分支静脉阻塞相关黄斑水肿不同治疗方案疗效评价[J].眼科新进展,2022,42(10):806-810.[doi:10.13389/j.cnki.rao.2022.0166]
　LIANG Pei,WANG Tan,LI Donghui,et al.Evaluation on the efficacy of different treatment options for macular edema in patients with branch retinal vein occlusion[J].Recent Advances in Ophthalmology,2022,42(10):806-810.[doi:10.13389/j.cnki.rao.2022.0166]
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
42卷
期数:
2022年10期
页码:
806-810
栏目:
应用研究
出版日期:
2022-10-05

文章信息/Info

Title:
Evaluation on the efficacy of different treatment options for macular edema in patients with branch retinal vein occlusion
作者:
梁沛; 王谭; 李东辉; 陈有信; 闵寒毅
061000　河北省沧州市，沧州市中心医院眼二科（梁沛）；100730　北京市，中国医学科学院 北京协和医学院 北京协和医院眼科 中国医学科学院眼底病重点实验室（王谭，李东辉，陈有信，闵寒毅）
Author(s):
LIANG Pei1; WANG Tan2; LI Donghui2; CHEN Youxin2; MIN Hanyi2
1.The Second Department of Ophthalmology,Cangzhou Central Hospital,Cangzhou 061000,Hebei Province,China
2.Department of Ophthalmology,Peking Union Medical College Hospital & Chinese Academy of Medical Sciences;Key Laboratory of Ocular Fundus Diseases,Chinese Academy of Peking Union Medical College,Beijing 100730,China
关键词:
视网膜分支静脉阻塞; 黄斑水肿; 地塞米松玻璃体内植入剂; 抗血管内皮生长因子
Keywords:
branch retinal vein occlusion;  macular edema;  dexamethasone intravitreal implant;  anti-vascular endothelial growth factor
分类号:
R774
DOI:
10.13389/j.cnki.rao.2022.0166
文献标志码:
A
摘要:
目的　比较单纯玻璃体内注射抗血管内皮生长因子（VEGF）药物和联合应用地塞米松玻璃体内植入剂治疗视网膜分支静脉阻塞（BRVO）相关黄斑水肿（ME）的效果。方法　回顾性分析BRVO相关ME的102例（102眼）患者的临床资料，分为两组，A组为单纯玻璃体内注射抗VEGF药物组（治疗期间接受任何一种抗VEGF药物），B组为玻璃体内注射抗VEGF药物和地塞米松玻璃体内植入剂组（不分先后顺序，治疗期间使用两种药物）。每月随访，共随访6个月及以上，末次注射后，连续3次随访均无视网膜下液，黄斑中心区厚度（CMT）变化≤50 μm，且 CMT≤250 μm为观察终点。比较两组患者玻璃体内注药次数、治疗前及治疗后最佳矫正视力（BCVA）、眼压、CMT。结果　两组患者经治疗后均能有效改善BCVA及降低CMT，A组患者玻璃体内注药次数为（4.59±2.83）次，B组患者玻璃体内注药次数为（3.02±1.62）次，两组比较差异有统计学意义（P=0.00）。治疗前后，A组患者BCVA（logMAR）从0.77±0.47提高到0.48±0.44（P=0.00），B组患者BCVA从0.73±0.45提高到0.42±0.35（P=0.00），A组患者CMT从（403.02±147.70）μm降低到（230.17±21.82）μm（P=0.00），B组患者CMT从（393.96±94.61）μm降低到（236.87±22.98）μm（P=0.00），但观察终点两组患者BCVA和CMT比较差异均无统计学意义（均为P>0.05）。B组患者中玻璃体内注射地塞米松玻璃体内植入剂后1个月内出现眼压升高至≥25 mmHg（1 kP=7.5 mmHg）的概率为14.6%，但局部应用抗青光眼药物均能控制。结论　单纯玻璃体内注射抗VEGF药物和联合应用地塞米松玻璃体内植入剂治疗BRVO相关ME均能起到很好的临床效果，且观察期内联合应用地塞米松玻璃体内植入剂的患者玻璃体内注药次数较少。
Abstract:
Objective　To compare the efficacy of intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) drugs alone and its combination with dexamethasone intravitreal implant in the treatment of macular edema (ME) of patients with branch retinal vein occlusion (BRVO). Methods　The clinical data of 102 BRVO patients (102 eyes) with ME were retrospectively analyzed. The patients were divided into two groups: the patients in Group A were treated with intravitreal injection of anti-VEGF drugs (any anti-VEGF drug was administered); the patients in Group B were treated with intravitreal injection of anti-VEGF drugs and dexamethasone intravitreal implant (two kinds of drugs were administered during treatment, regardless of order). Follow up monthly for at least 6 months. There was no subretinal fluid and the change of central macular thickness (CMT) was ≤ 50 μm, with CMT ≤ 250 μm as the end point in all three consecutive follow-ups after the last injection. The times of intravitreal injections, best corrected visual acuity (BCVA), intraocular pressure (IOP) and CMT before and after treatment in the two groups were compared. Results　The BCVA and CMT in both groups improved significantly after the treatment. The number of intravitreal injections in group A was 4.59±2.83, and that of group B was 3.02±1.62, showing a significant difference (P=0.00). Before and after the treatment, the BCVA (logMAR) of group A increased from 0.77±0.47 to 0.48±0.44 (P=0.00), and that of group B increased from 0.73±0.45 to 0.42±0.35 (P=0.00). The CMT in group A decreased from (403.02±147.70) μm to (230.17±21.82) μm (P=0.00), and that in group B decreased from (393.96±94.61) μm to (236.87±22.98) μm (P=0.00). However, there were no significant differences in BCVA and CMT between the two groups in the observation end point (P>0.05). In group B, the IOP of 14.6% of patients treated with dexamethasone intravitreal implant increased to ≥25 mmHg (1 kPa=7.5 mmHg) within one month after the therapy and could be controlled by topical application of anti-glaucoma drugs. Conclusion　Intravitreal injection of anti-VEGF drugs alone and combination with dexamethasone intravitreal implants are both effective in the treatment of ME related to BRVO, and combination with dexamethasone intravitreal implantation can reduce the number of intravitreal injections during the observation period.

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更新日期/Last Update: 2022-10-05