[1]李素华,高永峰. 比较单独黄斑局灶/格栅样光凝术和联合雷珠单抗治疗糖尿病性黄斑水肿的疗效[J].眼科新进展,2015,35(6):566-568.[doi:10.13389/j.cnki.rao.2015.0153]
　LI Su-Hua,GAO Yong-Feng. Efficacy of macular focal / grid photocoagulation combined with ranibizumab for diabetic macular edema[J].Recent Advances in Ophthalmology,2015,35(6):566-568.[doi:10.13389/j.cnki.rao.2015.0153]
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 比较单独黄斑局灶/格栅样光凝术和联合雷珠单抗治疗糖尿病性黄斑水肿的疗效
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
35卷
期数:
2015年6期
页码:
566-568
栏目:
应用研究
出版日期:
2015-06-05

文章信息/Info

Title:
 Efficacy of macular focal / grid photocoagulation combined with ranibizumab for diabetic macular edema
作者:
 李素华; 高永峰
 473000　河南省南阳市，南阳市中心医院眼科
Author(s):
 LI Su-Hua ;  GAO Yong-Feng
 Department of Ophthalmology , Nanyang Central Hospital, Nanyang 473000 , Henan Province , China
关键词:
 ; 糖尿病性黄斑水肿; 激光光凝术; 雷珠单抗
Keywords:
 ; diabetic macular edema; laser photocoagulation ; ranibizumab
DOI:
10.13389/j.cnki.rao.2015.0153
文献标志码:
A
摘要:
 目的　比较单用黄斑局灶／格栅样光凝术、玻璃体内注射雷珠单抗（Ｒａｎｉｂｉｚｕｍａ）及联合黄斑局灶／格栅样光凝术和玻璃体内注射雷珠单抗治疗糖尿病性黄斑水肿（ｄｉａｂｅｔｉｃｍａｃｕｌａｒｅｄｅｍａ，ＤＭＥ）的有效性及安全性。方法　选取２０１２年１月至２０１３年６月南阳市中心医院收治的１０２例（１０２眼）ＤＭＥ患者，随机分为单纯黄斑局灶／格栅样光凝术组（Ａ组）、单纯玻璃体内注射泪珠单抗组（Ｂ组）和黄斑局灶／格栅样光凝术联合玻璃体内注射雷珠单抗组（Ｃ组）。分别于术前、术后３个月、６个月、１２个月行最佳矫正视力（ｂｅｓｔｃｏｒｒｅｃｔｅｄｖｉｓｕａｌａｃｕｉｔｙ，ＢＣＶＡ）、裂隙镜、眼压、光学相干断层扫描、眼底荧光血管造影等检查，比较三种处理方式的疗效和安全性。结果　三种治疗方式均能改善ＤＭＥ患者ＢＣＶＡ、黄斑中心凹厚度（ｃｅｎｔｒａｌｍａｃｕｌａｒｔｈｉｃｋｎｅｓｓ，ＣＭＴ）、视网膜新生血管（ｒｅｔｉｎａｌｎｅｏｖａｓｃｕｌａｒｉｚａｔｉｏｎ，ＲＮＶ）渗漏，但Ｂ、Ｃ组疗效优于Ａ组（Ｐ＜０．０５）。Ｂ、Ｃ组患者ＢＣＶＡ改善情况差异无统计学意义（Ｐ＞０．０５），但Ｃ组患者ＣＭＴ及ＲＮＶ渗漏改善情况优于Ｂ组（Ｐ＜０．０００１），表现出更理想且持久的治疗效果［ＢＣＶＡ：０．２５００±０．０９４１；ＣＭＴ：（－１６２．４０±２６．３４）μｍ；ＲＮＶ渗漏面积：（－１９．６３±４．８７）ｍｍ２］，且无光凝术及雷珠单抗相关的并发症发生。结论　黄斑局灶／格栅样光凝术联合玻璃体内注射雷珠单抗能迅速减轻ＤＭＥ及新生血管形成，从而提高患者视力，其疗效优于单纯黄斑局灶／格栅样光凝术和联合雷珠单抗。
Abstract:
 Objective To explore the effects and safety of macular focal/grid laser photocoagulation. intravitreal injection of ranibizumab or a combination of above two methods for diabetic macular edema ( DME ) . Methods A total of 102 patients (102 eyes) with DME hospitalized in Nanyang Central Hospital were randomly divided into focal/grid laser photocoagulation ( group A) . intravitreal injection of ranibizumab group ( group B) , focal/grid laser photocoagulation combined with intravitreal injection of ranibizumab group ( group C) . The best corrected visual acuity ( BCVA) , slit-lamp ,intraocular pressure , optical coherence tomography , fundus fluorescein angiography were performed at pre-operation and postoperative 3 months .6 months ,12 months. Results The BCVA . central macular thickness ( CMT ) and retinal neovascularization ( RNV ) leakage were improved in all three groups,but the group B and C were better than the group A (P < 0. 05) . No significant difference was found between group B and group C for BCVA ( P > 0. 05 ) . However , compared with group B , obvious more improvement in CMT and RNV leakage area were achieved in group C [P < 0. 000 I ; BCVA : 0. 250 0 + 0. 094 I ;CMT : ( - 162. 40 +26. 34 ) p m ; RNV : ( - 19. 63 +4. 87 ) mm2 ] . No related complication appeared. Conclusion The focal/grid laser photocoagulation combined with intravitreal injection of ranibizumab remarkably ameliorates the macular edema and RNV, improve the visual acuity in the short-term.its efficacy is better than the single macular focal/grid laser photocoagulation or intravitreal injection of ranibizumab.

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更新日期/Last Update: 2015-06-01