康柏西普玻璃体腔注射治疗CRVO继发黄斑水肿的临床研究

发布时间：2018-06-25 12:40

本文选题：视网膜中央静脉阻塞 + 注射　；参考：《青岛大学》2017年硕士论文

【摘要】：目的:探讨玻璃体腔内注射康柏西普治疗视网膜中央静脉阻塞(central retinal vein occlusion,CRVO)继发黄斑水肿(macular edema,ME)的效果。方法:筛选自2015年4月到2015年10月在本院经临床确诊为视网膜中央静脉阻塞继发黄斑水肿的患者15例(15眼),进行回顾性研究。在给予玻璃体腔注药前检查患者全身情况,有无全身疾病、不良嗜好;全面的眼科检查,并备案治疗前的视力情况、眼压、光学相干断层扫描(optical coherence tomography,OCT)、眼底照相等一系列眼科必须检查。开始治疗后记录并分析注射后1w、1m、3m、6m患者的最佳矫正视力(best-corrected visual acuity,BCVA)、眼压、黄斑中心凹的视网膜厚度(central macular thickness,CMT)、眼底照相,以此用来和治疗前做出比较。同时采用配对t检验对最佳矫正视力(BCVA)和黄斑中心凹的视网膜厚度(CMT)两组数据进行统计学分析。结果:全部患者在玻璃体腔内注射康柏西普后最佳矫正视力均得到了不同程度的提高。治疗前BCVA为1.15±0.22,治疗后1w、1m、3m、6m的BCVA分别为0.98±0.25、0.92±0.26、0.82±0.32、0.70±0.29,治疗前与治疗后每次所得结果相比统计学分析差异有意义(p0.05);应用光学相干断层扫描(optical coherence tomography,OCT)测量黄斑中心凹的视网膜厚度(CMT)明显变薄,治疗前为596.13±54.30μm,治疗后1w、1m、3m、6m分别为258.80±32.00μm、245.87±74.11μm、254.26±127.76μm、168.07±23.43μm,治疗前和治疗后所得结果经过统计学分析差异有意义(p0.05)。在这个连续的随访过程中,部分患者在给予干预治疗后会再次出现黄斑水肿,重复注射后黄斑中心凹的视网膜厚度(CMT)仍然可以明显的降低。结论:玻璃体腔内注射康柏西普治疗CRVO继发黄斑水肿,患者短期中心视力有所提高,黄斑水肿减轻,黄斑中心凹的视网膜厚度(CMT)数值和治疗前比较降低。说明该药在对抗视网膜中央静脉阻塞继发的黄斑水肿有明显的优势,效果显著,最终达到提高患者视力的目的,且操作方法相对简单,普遍能为患者所认可。当然,在长期观察过程中发现有病情反复的现象,再次经过玻璃体腔注入康柏西普注射液后测量相干光学断层扫描检查发现水肿获得了减轻,这说明该药周期尚待考量、研究,需要反复多次注射才能控制病情。
[Abstract]:Objective: to investigate the effect of intravitreal injection of Compactopril in the treatment of secondary macular edema (macular edemame) of central retinal vein occlusion (central retinal vein occlusion). Methods: 15 patients (15 eyes) with macular edema following central retinal vein occlusion were selected from April 2015 to October 2015. Examination of the patients' general condition, whether they have any systemic diseases, bad habits, comprehensive ophthalmological examination, and the record of their eyesight and intraocular pressure before they are given intravitreal injection. Optical coherence tomography (optical coherence tomography Oct), fundus photography and other ophthalmology must be examined. The best-corrected visual acuteness BCVA, intraocular pressure, retinal thickness of macular fovea (central macular thicknessn), and fundus photography were recorded and analyzed 1 week after treatment, and compared with those before treatment. The results were as follows: (1) at the beginning of treatment, the best corrected visual acuity (BCVA), intraocular pressure (IOP), retinal thickness of macular fovea (central macular thicknessn), and fundus photography were recorded and analyzed. The best corrected visual acuity (BCVA) and retinal thickness (CMT) of macular fovea were statistically analyzed by paired t test. Results: the best corrected visual acuity (BCVA) of all the patients was improved in varying degrees after intravitreal injection of Combortopril. BCVA was 1.15 卤0.22 before treatment and 0.98 卤0.25 卤0.92 卤0.32 卤0.70 卤0.29 at 1 week after treatment. The results before and after treatment were statistically significant (p0.05). The retinal thickness of macular fovea was measured by optical coherence tomography (optical coherence). It was 596.13 卤54.30 渭 m before treatment and 258.80 卤32.00 渭 m / 3 m at 1 week after treatment, respectively. The results were significantly different before and after treatment (p 0.05). During this continuous follow-up, macular edema was found again in some patients after intervention, and the retinal thickness (CMT) of the fovea was significantly decreased after repeated injection. Conclusion: in the treatment of CRVO secondary macular edema, the short-term central visual acuity was improved, macular edema was alleviated, and the retinal thickness (CMT) of macular fovea was decreased. The results showed that the drug had obvious advantages in the treatment of macular edema secondary to central retinal vein occlusion and achieved the goal of improving the visual acuity of the patients. The method of operation was relatively simple and could be generally accepted by the patients. Of course, during the long period of observation, it was found that there was a recurrence of the disease. After the injection of Compathep injection into the vitreous body, the measurement of coherence optical tomography showed that the edema had been alleviated, which indicated that the period of the drug was still to be considered. Multiple injections are needed to control the condition.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R774

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