抗VEGF药物玻璃体内注射治疗视网膜血管样条纹继发脉络膜新生血管的远期观察

发布时间：2018-09-08 15:34

【摘要】：目的探讨视网膜血管样条纹继发脉络膜新生血管(choroidal neovascularization,CNV)抗VEGF治疗的远期疗效。方法回顾分析接受玻璃体内注射抗VEGF药物的视网膜血管样条纹继发CNV患者,观察至少3 a后患者视力改善情况、视网膜及脉络膜活动性病灶消退情况等指标。结果纳入分析的21例(30眼)患者中,眼内注射次数6~18(10.0±2.4)次。随访36~54(39.5±2.2)个月。患者首次接受治疗时BCVA为(31.00±3.81)个字母数,观察终点时最佳矫正视力为(34.00±0.35)个字母数,总体差异无统计学意义(P=0.600)。患者治疗前视网膜中央厚度为(406.21±21.23)μm,随访终末时为(251.16±36.36)μm,减少值为(150.21±24.43)μm,治疗前后视网膜中央厚度比较差异有统计学意义(P=0.002)。30眼中16眼在初期治疗后视力明显提升,但随访中出现病变复发活跃后视力再次下降至基线水平;10眼在病变过程中出现不同程度黄斑下萎缩及瘢痕化改变,随访过程及随访终末视力与基线视力差异均无统计学意义(均为P0.05);4眼由于初始CNV未累及黄斑区,在治疗随访过程中CNV稳定。结论由于病变的高复发性及强活跃性,抗VEGF药物治疗血管样条纹继发CNV远期预后并不理想,治疗仅发挥了一定维持视功能的作用。
[Abstract]:Objective to investigate the long-term effect of anti-VEGF treatment with retinal vascular stripe secondary choroidal neovascularization (choroidal neovascularization,CNV). Methods Retinal vascular stripe secondary CNV patients receiving intravitreous injection of anti- VEGF drugs were retrospectively analyzed. The visual acuity of the patients and the regression of the active focus of retina and choroid were observed after at least 3 years. Results in 21 patients (30 eyes), the times of intraocular injection were 60.18 (10.0 卤2.4) times. The follow-up period was 36 卤54 (39.5 卤2.2) months. The BCVA was (31.00 卤3.81) letters at the first time of treatment, and the best corrected visual acuity (BCVA) was (34.00 卤0.35) letters at the end point. There was no significant difference between the two groups (P0. 600). The central retinal thickness was (406.21 卤21.23) 渭 m before treatment and (251.16 卤36.36) 渭 m at the end of follow-up. The decrease was (150.21 卤24.43) 渭 m. However, the visual acuity of 10 eyes decreased again to the baseline level after the recurrence and activity of the lesion during the follow up, 10 eyes showed various degrees of submacular atrophy and scarring in the course of the lesion. There was no significant difference between the visual acuity and baseline visual acuity in the follow-up process and the final visual acuity (P0.05) CNV was stable in 4 eyes due to the absence of macular area in the initial CNV. Conclusion because of the high recurrence and high activity of the disease, the long-term prognosis of the treatment of vascular stripe secondary CNV with anti- VEGF drugs is not ideal, and the treatment only plays a role in maintaining visual function.
【作者单位】：云南省第二人民医院眼科;
【基金】：云南省教育厅科学研究基金(编号:2015FB076) 云南省科技厅-昆明医科大学应用基础研究联合资金(编号:2015C043Y) 云南省卫生和计划生育委员会医学后备人才培养计划(编号:H-201636)~~
【分类号】：R773.4

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