玻璃体注射雷珠单抗治疗视网膜中央静脉阻塞继发黄斑水肿的短期效果

发布时间：2018-09-10 07:32

【摘要】：目的探讨玻璃体注射雷珠单抗治疗视网膜中央静脉阻塞(CRVO)继发黄斑水肿的效果。设计前瞻性比较性病例系列。研究对象46例CRVO继发黄斑水肿患者(46眼)。方法采用随机分层法分为对照组(n=23例,予以玻璃体注射4 mg/0.1ml曲安奈德)和观察组(n=23例,玻璃体注射0.5 mg/0.05ml雷珠单抗)。于治疗后1、4、8、12、24周,观察治疗效果。主要指标最佳矫正视力(BCVA),黄斑中心凹厚度(CMT),眼压。结果(1)治疗后1、4、8、12、24周,两组患者视力改善有效率对比差异无统计学意义(P=0.760、0.765、0.552、0.767、0.555);(2)两组患者不同时间点BCVA组内比较差异均有统计学意义(F=4.373,P=0.000;F=3.472,P=0.008)。在各时间点上,两组患者BCVA比较差异无统计学意义(P=1.000、0.339、0.484、0.886、0.502、0.560);(3)两组患者不同时间点CMT组内比较差异均存在统计学意义(F=3.891,P=0.000;F=3.571,P=0.002)。在各时间点上,两组患者CMT比较差异无统计学意义(P=0.855、0.869、0.915、0.892、0.874、0.564)。(4)观察组不同时间点眼压比较差异无统计学意义(F=2.341,P=0.137),对照组组内比较差异有统计学意义(F=2.569,P=0.049)。在治疗后4周和24周,观察组患者眼压值明显低于对照组(P=0.008、0.042),其余时间点,两组患者眼压值差异无统计学意义(P=0.216、0.161、0.242)。(5)在随访过程中,对照组患者出现2例(8.70%)眼压升高,观察组患者未出现其他并发症。结论玻璃体注射雷珠单抗治疗CRVO继发黄斑水肿效果较好,在提高BCVA及降低CMT方面与曲安奈德相当,但在避免眼压升高方面优于曲安奈德,治疗安全性较高。
[Abstract]:Objective to investigate the effect of vitreous injection of Leizhu McAb in the treatment of macular edema secondary to central retinal vein occlusion (CRVO). Design prospective comparative case series. Participants 46 patients (46 eyes) with macular edema secondary to CRVO were studied. Methods randomly divided into control group (n = 23) (n = 23) and observation group (n = 23) by vitreous injection of triamcinolone acetonide (n = 23) and control group (n = 23) by intravitreous injection of triamcinolone acetonide for 0.5 mg/0.05ml. The therapeutic effect was observed after treatment for 24 weeks. Main outcome measures (BCVA), macular foveal thickness (CMT), intraocular pressure. Results (1) there was no significant difference in the effective rate of visual acuity between the two groups (P < 0. 776 ~ 0. 765 卤0. 557 / 0. 555); (2). There were significant differences between the two groups in the BCVA group at different time points (F4. 373P0. 000F3.472P0. 008). At each time point, there was no significant difference in BCVA between the two groups (P 1.0000.339U 0.484U 0.886U 0.502U 0.560); (3). There were significant differences between the two groups in CMT group at different time points (F 3.891P 0.000 P 0.571P 0.002). At each time point, there was no significant difference in CMT between the two groups (P < 0. 855). There was no significant difference in intraocular pressure (IOP) at different time points between the two groups (P < 0. 855, P = 0. 869). There was no significant difference in intraocular pressure at different time points in the observation group (P < 0. 049), but in the control group, there was a significant difference between the two groups (P < 0. 049). At the 4th and 24th week after treatment, the IOP in the observation group was significantly lower than that in the control group (P0. 008 / 0. 042). At other time points, there was no significant difference in IOP between the two groups (P0. 216U 0. 161 ~ 0. 242). (5). During the follow-up, 2 patients (8. 70%) in the control group had intraocular pressure elevation. There were no other complications in the observation group. Conclusion vitreous injection of Lei Zhu McAb is effective in the treatment of secondary macular edema in CRVO. It is similar to triamcinolone acetonide in increasing BCVA and reducing CMT, but it is superior to triamcinolone acetonide in avoiding the elevation of intraocular pressure.
【作者单位】：信阳市中心医院眼科;
【基金】：河南省医学科技攻关计划项目(201404035)
【分类号】：R774

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