玻璃体内注射雷珠单抗联合激光光凝治疗Coats病的疗效观察

发布时间：2018-02-09 11:29

本文关键词： 雷珠单抗玻璃体内注射激光光凝 Coats病　出处：《眼科新进展》2017年03期 　论文类型：期刊论文

【摘要】：目的观察玻璃体内注射雷珠单抗联合激光光凝治疗Coats病的效果。方法选择自2012年8月至2015年12月经眼底荧光血管造影及光学相干断层扫描诊断为Coats病的患者18例(18眼)为研究对象,所有患者先接受玻璃体内注射雷珠单抗,1周后在眼底荧光血管造影引导下行视网膜激光光凝术,必要时进行重复治疗。术后对最佳矫正视力及黄斑中心凹视网膜厚度(central macular thickness,CMT)进行观察,随访时间为16~24个月,平均18.8个月。结果雷珠单抗的平均注射次数为2.6次,激光光凝次数为1.8次。术前最佳矫正视力为(0.81±0.28)LogMAR,末次随访时最佳矫正视力为(0.76±0.37)LogMAR(P=0.396)。视力提高大于0.3 LogMAR者3例(16.7%),视力改变在0.3 LogMAR以内者13例(72.2%),视力下降大于0.3 LogMAR者2例(11.1%)。术前CMT为(341.11±67.97)μm,末次随访时为(277.83±51.59)μm(P=0.030)。末次随访时最佳矫正视力与术前最佳矫正视力显著相关(r=0.817,P0.001)。伴有黄斑中心凹下硬性渗出的患眼末次随访时最佳矫力较不伴有硬性渗出者差(P=0.044)。结论玻璃体内注射雷珠单抗联合激光光凝是治疗Coats病的有效方法,可以稳定视力,降低CMT。术后视力与术前视力及黄斑中心凹下硬性渗出有关。
[Abstract]:Objective to observe the effect of intravitreal injection of Lei Zhu McAb and laser photocoagulation in the treatment of Coats's disease. Methods from August 2012 to 2015, 18 patients with Coats's disease were diagnosed by fundus fluorescein angiography and optical coherence tomography. (18 eyes). All the patients were treated with intravitreous injection of Lei Zhu McAb for 1 week under the guidance of fundus fluorescein angiography for retinal laser photocoagulation. The best corrected visual acuity (BCVA) and retinal thickness of macular fovea were observed. The follow-up time was 16 ~ 24 months (mean 18.8 months). The number of laser photocoagulation was 1.8.The preoperative best corrected visual acuity (BCVA) was 0.81 卤0.28g LogMAR, and at the last follow-up the best corrected visual acuity (BCVA) was 0.76 卤0.37mg / L (0.396g). The visual acuity improved more than 0.3 LogMAR in 3 cases, the visual acuity changed within 0.3 LogMAR in 13 cases (72.22%), and the visual acuity decreased more than 0.3 LogMAR in 2 cases (11.1g / L). CMT was 341.11 卤67.97 渭 m before operation and 277.83 卤51.59 渭 m at the last follow-up. There was a significant correlation between the best corrected visual acuity and the preoperative best corrected visual acuity at the last follow-up. Conclusion intravitreal injection of Lei Zhu McAb combined with laser photocoagulation is an effective method for the treatment of Coats's disease. It can stabilize vision and reduce CMT. Postoperative visual acuity is related to preoperative visual acuity and hard exudation under fovea macula.
【作者单位】：南昌大学第二附属医院眼科;
【分类号】：R779.63

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