[1]龙婷,陈佳,杜磊,等.雷珠单抗联合玻璃体切割术治疗糖尿病视网膜病变合并新生血管性青光眼[J].眼科新进展,2017,37(12):1182-1184.[doi:10.13389/j.cnki.rao.2017.0298]
 LONG Ting,CHEN Jia,DU Lei,et al.Clinical outcomes of ranibizumab combined with vitrectomy in treatment of patients with diabetic retinopathy accompanied by neovascular glaucoma[J].Recent Advances in Ophthalmology,2017,37(12):1182-1184.[doi:10.13389/j.cnki.rao.2017.0298]
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
37卷
期数:
2017年12期
页码:
1182-1184
栏目:
应用研究
出版日期:
2017-12-05

文章信息/Info

Title:
Clinical outcomes of ranibizumab combined with vitrectomy in treatment of patients with diabetic retinopathy accompanied by neovascular glaucoma
作者:
龙婷陈佳杜磊邢怡桥
430071 湖北省武汉市,武汉大学人民医院眼科中心
Author(s):
LONG TingCHEN JiaDU LeiXING Yi-Qiao
Eye Center,Renmin Hosipital of Wuhan University,Wuhan 430071,Hubei Province,China
关键词:
糖尿病视网膜病变新生血管性青光眼雷珠单抗玻璃体切割术
Keywords:
diabetic retinopathyneovascular glaucomaranibizumabpars plana vitrectomy
分类号:
R774
DOI:
10.13389/j.cnki.rao.2017.0298
文献标志码:
A
摘要:
目的 观察雷珠单抗联合玻璃体切割术治疗糖尿病视网膜病变合并新生血管性青光眼的临床效果。方法 回顾性分析糖尿病视网膜病变合并新生血管性青光眼并行雷珠单抗联合玻璃体切割术的16例(16眼)患者的临床资料。术后随访6个月,对比观察手术前后眼压、最佳矫正视力、虹膜新生血管、房角开闭情况等,并记录并发症情况。结果 术前患眼眼压为(42.54±16.52)mmHg(1 kPa=7.5 mmHg)。玻璃体内注射雷珠单抗后1 d眼压为(38.78±11.38)mmHg,与术前相比差异无统计学意义(P>0.05);玻璃体切割术后1周眼压(45.30±12.20)mmHg,与术前相比差异无统计学意义(P>0.05);术后1个月、3个月、6个月眼压分别为(27.56±19.38)mmHg、(20.49±18.66)mmHg、(19.79±16.53)mmHg,与术前相比差异均有统计学意义(均为P<0.05)。随访结束时,10眼(62.5%)虹膜新生血管完全消退,6眼(37.5%)虹膜新生血管明显减少。结论 雷珠单抗联合玻璃体切割术治疗糖尿病视网膜病变合并新生血管性青光眼,可有效降低眼压,轻度提高视力,术后并发症少。
Abstract:
Objective To investigate the efficacy of ranibizumab combined with pars plana vitrectomy (PPV) in treatment of patients with diabetic retinopathy together with neovascular glaucoma.Methods A retrospective analysis of 16 patients (16 eyes) with diabetic retinopathy accompanied by neovascular glaucoma underwent vitrectomy combined with ranibizumab between June 2013 and June 2017 was conducted.Data were collected on patients’ intraocular pressure (IOP),best-corrected visual acuity (BCVA),iris neovascularization,chamber angle changes before and after surgery,and the postoperative complications were recorded.Results No significant difference was approached in IOP before surgery and 1 day after ranibizumab injection [(42.54±16.52)mmHg vs.(38.78±11.38)mmHg,1 kPa=7.5 mmHg] (P>0.05).And there was also no significant difference in the IOP before surgery and 1 week after vitrectomy [(45.30±12.20)mmHg vs.(42.54±16.52)mmHg] (P>0.05);The IOP at 1 month,3 months and 6 months after surgery was (27.56±19.38) mmHg,(20.49±18.66) mmHg and (19.79±16.53) mmHg,respectively,which were significantly different from preoperative IOP (all P<0.05).At the end of the follow-up,iris neovascularization completely disappeared in 10 eyes (62.5%) and iris neovascularization was significantly lessened in 6 eyes (37.5%).Conclusion Ranibizumab with PPV for diabetic retinopathy and neovascular glaucoma can effectively reduce intraocular pressure and postoperative complications as well as improve visual acuity slightly.

参考文献/References:

[1] 葛坚,王宁利,黎晓新,姚克,孙兴怀.眼科学[M].北京:人民卫生出版社,2015:287.
GE J,WANG NL,LI XX,YAO K,SUN XH.Ophthalmology[M].Beijing:People’s Medical Publishing House,2015:287.
[2] TRIPATHI RC,LI J,TRIPATHI BJ,CHALAM KV,ADAMIS AP.Increased level of vascular endothelial growth factor in aqueous humor of patients with neovascular glaucoma[J].Ophthalmology,1998,105(2):232-237.
[3] VASDUV D,BLAIR MP,GALASSO J,KAPUR R,VAJARANANT AT.Intravitreal bevacizumab for neovascular glaucoma[J].J Ocul Pharmaeol Ther,2009,25(5):453-458.
[4] 吴敏,薛黎萍,和丹,胡竹林,肖丽波.23G玻璃体切割术联合全视网膜光凝和二期Ahmed引流阀植入治疗新生血管性青光眼疗效探讨[J].中国实用眼科杂志,2015,33(11):1284-1287.
WU M,XUE LP,HE D,HU ZL,XIAO LB.The outcome of 23 Gauge vitrectomy combined with pan retina photocoagulation followed by Ahmed glaucoma valve implantation in neovascular glaucoma[J].Chin J Pract Ophthalmol,2015,33(11):1284-1287.
[5] 中华医学会眼科学会眼底病学组.我国糖尿病视网膜病变临床诊疗指南(2014年)[J].中华眼科杂志,2014,50(11):851-865.
FUNDUS DISEASES GROUP OF OPHTHALMOLOGY SOCIETY OF CHINESE MEDICAL ASSOCIATION.Guidelines for clinical diagnosis and treatment of diabetic retinopathy in China (2014)[J].Chin J Ophthalmol,2014,50 (11):851-865.
[6] 李凤鸣,谢立信.中华眼科学[M].北京:人民卫生出版社,2014:1888-1889.
LI FM,XIE LX.Chinese ophthalmology[M].Beijing:People’s Medical Publishing House,2014:1888-1889.
[7] CLUGRU D,CLUGRU M.Neovascular glaucoma--etipa-thogeny and diagnosis[J].Oftalmologia,2012,56(2):3-14.
[8] HOU XR,MIAO H,TAO Y,LI XX,WONG IY.Expression of cytokines on the iris of patients with neovascular glaucoma[J].Acta Ophthalmol,2014,93(2):100-104.
[9] CHALAM KV,BRAR VS,MURTHY RK.Human ciliary epithelium as a source of synthesis and secretion of vascular endothelial growth factor in neovascular glaucoma[J].Ophthalmology,2014,132(11):1350-1354.
[10] NOMA H,MIMURA T,YASUDA K,SHIMURA M.Vascular endothelial growth factor and its soluble receptors-1 and -2 in iris neovascularization and neovascular glaucoma[J].Ophthalmologica,2014,232(2):102-109.
[11] WANG D,CHOI KS,LEE SJ.Serum concentration of vascular endothelial growth factor after bilateral intravitreal injection of bevacizumab[J].Korean J Ophthalmol,2014,28(1):32-38.
[12] MATSUYAMA K,OGATA N,MATSUOKA M,WADA M,TAKAHASHI K,NISHIMURA T.Plasma levels of vascular endothelial growth factor and pigment epithelium-derived factor before and after intravitreal injection of bevacizumab[J].Br J Ophthalmol,2010,94(9):1215-1218.
[13] 师留坤,杨瑾.抗VEGF药物辅助治疗新生血管性青光眼[J].国际眼科纵览,2015,39(6):376-381.
SHI LK,YANG J.Adjuvant treatment of neovascular glaucoma with anti-VEGF[J].Int Rev Ophthalmol,2015,39(6):376-381.
[14] 刘红,秦平.玻璃体腔内注射Avastin联合睫状体光凝治疗新生血管性青光眼[J].新乡医学院学报,2013,30(3):216-217,220.
LIU H,QIN P.Intravitreal injection of Avastin combined with cyclophotocoagulation for neovascular glaucoma[J].J Xinxiang Med Coll,2013,30(3):216-217,220.
[15] BROWN DM,NGUYEN QD,MARCUS DM,BOYER DS,PATEL S,FEINER L,et al.Long-term outcomes of ranibizumab therapy for diabetic macular edema:the 36-month results from two phase III trials:RISE and RIDE[J].Ophthalmology,2013,120(10):2013-2022.
[16] SUN Y,YONG L,PENG Z,HUI JW,XIAN RH,ZE QR,et al.Anti-VEGF treatment is the key strategy for neovascular glaucoma management in the short term[J].BMC Ophthalmol,2016,16(1):150.

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更新日期/Last Update: 2017-12-08