[1]高瑞莹,李仕永,陈晖,等.玻璃体内注射雷珠单抗联合糖皮质激素治疗Ⅱ型视盘血管炎继发黄斑水肿的疗效观察[J].眼科新进展,2019,39(5):469-472.[doi:10.13389/j.cnki.rao.2019.0108]
　GAO Rui-Ying,LI Shi-Yong,CHEN Hui,et al.Observation of intravitreal Ranibizumab injection combined with glucocorticoid in treatment for macular edema secondary to type Ⅱ optic disc vasculitis[J].Recent Advances in Ophthalmology,2019,39(5):469-472.[doi:10.13389/j.cnki.rao.2019.0108]
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玻璃体内注射雷珠单抗联合糖皮质激素治疗Ⅱ型视盘血管炎继发黄斑水肿的疗效观察/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
39卷
期数:
2019年5期
页码:
469-472
栏目:
应用研究
出版日期:
2019-05-05

文章信息/Info

Title:
Observation of intravitreal Ranibizumab injection combined with glucocorticoid in treatment for macular edema secondary to type Ⅱ optic disc vasculitis
作者:
高瑞莹; 李仕永; 陈晖; 牛文哲
210008　江苏省南京市，南京大学医学院附属鼓楼医院眼科宁益眼科中心（高瑞莹，李仕永，陈晖）；210046　江苏省南京市，南京大学医学院附属泰康仙林鼓楼医院眼科（牛文哲）
Author(s):
GAO Rui-Ying; LI Shi-Yong; CHEN Hui; NIU Wen-Zhe
Nanjing Ningyi Eye Center，Department of Ophthalmology，Nanjing Drum Tower Hospital Affiliated to Nanjing University Medical School（GAO Rui-Ying，LI Shi-Yong，CHEN Hui），Nanjing 210008，Jiangsu Province，China；the Department of Ophthalmology，Taikang Xianlin Drum Tower Hospital，Affiliated to Nanjing University Medical School（NIU Wen-Zhe），Nanjing 210046，Jiangsu Province，China
关键词:
雷珠单抗; 糖皮质激素; 玻璃体内注射; Ⅱ 型视盘血管炎; 黄斑水肿
Keywords:
ranibizumab; glucocorticoid; intravitreal injection; type Ⅱ optic disc vasculitis; macular edema
分类号:
R774.6
DOI:
10.13389/j.cnki.rao.2019.0108
文献标志码:
A
摘要:
目的　探讨玻璃体内注射雷珠单抗联合糖皮质激素治疗Ⅱ型视盘血管炎继发黄斑水肿的临床疗效和安全性。方法　选取2013年4月至2017年6月就诊于我科的36例（36眼）Ⅱ型视盘血管炎患者分为2组，联合组17例和单纯组19例。联合组患者给予玻璃体内注射雷珠单抗联合糖皮质激素治疗（泼尼松片），单纯组患者仅给予糖皮质激素治疗。其中单纯组中有3例患者在病程中改变了治疗方案，3例患者的最佳矫正视力（best corrected visual acuity，BCVA）及黄斑中心凹视网膜厚度 （central retinal thickness，CRT）未计入结果，最终比较了17例联合组和16例单纯组患者的BCVA及CRT。记录所有患者治疗前的眼底表现、BCVA、眼压、光学相干断层扫描和眼底荧光素血管造影及治疗后1个月、3个月和6个月的眼底表现、BCVA、眼压和光学相干断层扫描情况。结果　联合组和单纯组治疗前BCVA分别是（0.96±0.33）logMAR和（0.92±0.36）logMAR，组间比较差异无统计学意义（P＞0.05）。2组患者在治疗后 1个月BCVA均有提高，联合组BCVA在治疗后3个月达到最佳，单纯组BCVA在治疗后6个月达到最佳，在治疗后1个月、3个月、6个月BCVA联合组均优于单纯组，差异均有统计学意义（均为P＜0.05）。联合组和单纯组在治疗后 1个月黄斑水肿均有明显减轻，联合组在治疗后3个月时CRT接近正常，单纯组在治疗后6个月时CRT接近正常，2组患者治疗后1个月的CRT、3个月的CRT组间比较差异均有统计学意义（均为P＜0.05），2组患者治疗后6 个月的CRT组间比较差异无统计学意义（P＞0.05）。结论　玻璃体内注射雷珠单抗联合糖皮质激素较单纯糖皮质激素治疗 Ⅱ 型视盘血管炎继发黄斑水肿能够更快地减轻患者的黄斑水肿并能提高患者的预后视力。
Abstract:
Objective　To investigate the clinical efficacy and safety of intravitreal Ranibizumab injection combined with glucocorticoid in treatment for macular edema secondary to type Ⅱ optic disc vasculitis.Methods　Thirty-six patients （36 eyes） with macular edema secondary to type Ⅱ optic disc vasculitis were selected from April 2013 to June 2017 in our hospital.Thirty-six patients were divided into two groups of whom seventeen patients （17 eyes） were in the combined group and nineteen patients （19 eyes） were in the simple group.The patients in the combined group were given intravitreal Ranibizumab injection combined with glucocorticoid treatment （prednisone tablets）.The patients in the simple group were given glucocorticoid treatment.The treatment plans of three patients in the simple group changed during the course of the treatment.The best corrected visual acuity （BCVA） and central retinal thickness （CRT） of three patients were not included in the results of statistical analysis.Finally，we compared the BCVA and CRT of 17 patients in the combined group and 16 patients in the simple group.We recorded the fundus manifestations，BCVA，intraocular pressure，optical coherence tomography and fundus fluorescein angiography before treatment and recorded the fundus manifestations，BCVA，intraocular pressure，optical coherence tomography for 1 week，1 month，2 months，3 months and 6 months after treatment.Results　Before treatment BCVA in combination group and simple group were （0.96±0.33）logMAR and （0.92±0.36） logMAR，respectively.Before treatment BCVA was no significant difference between the two groups （P>0.05）.The BCVA of the combined group and the simple group improved 1 month after treatment.The BCVA of the combined group reached the best after 3 months treatment.The BCVA of the simple group reached the best after 6 months treatment.The BCVA of the combined group were better than that of the simple group at the time points of 1 month，3 months and 6 months after treatment （all P＜0.05）.The macular edema in the combined group and the simple group were significantly alleviated at 1 month after treatment.The CRT in the combined group was closed to normal after 3 months treatment and the CRT in the simple group was closed to normal after 6 months treatment.There were significant differences in CRT between two groups at 1 month and 3 months after treatment （all P＜0.05）.There was no significant difference in CRT between two groups at 6 months after treatment （P>0.05）.Conclusion　Intravitreal Ranibizumab injection combined with glucocorticoid treatment can reduce macular edema and improve prognostic visual acuity more quickly than simple glucocorticoid treatment for macular edema secondary to type Ⅱ optic disc vasculitis patients.

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更新日期/Last Update: 2019-05-14