玻璃体内注射康柏西普与黄斑区光凝治疗视网膜分支静脉阻塞继发非缺血性黄斑水肿的临床对照研究

发布时间：2018-11-18 17:57

【摘要】：目的探讨玻璃体内注射康柏西普与黄斑区光凝治疗视网膜分支静脉阻塞(branch retinal vein occlusion,BRVO)继发非缺血性黄斑水肿的疗效和安全性。方法回顾分析临床确诊的BRVO继发非缺血性黄斑水肿患者50例(50眼),依据手术情况将患者分为2组,康柏西普组26例(26眼)患者接受按需治疗的玻璃体内注射,光凝组24例(24眼)患者接受标准的黄斑区格栅样光凝治疗黄斑水肿。2组分别于术后1周、1个月、2个月、3个月进行复查,观察患者的最佳矫正视力(best-corrected visual acuity,BCVA)和黄斑中心凹厚度(central macular thickness,CMT)的变化。对比分析2组患眼治疗前后BCVA、CMT的变化,并观察眼部和全身并发症的发生情况。结果治疗前2组患者的BCVA差异无统计学意义(P0.05)。康柏西普组和光凝组治疗后1周、1个月、2个月、3个月时BCVA均较治疗前提高,差异均有统计学意义(均为P0.05);康柏西普组与光凝组治疗后1周、1个月、2个月、3个月时组间比较均较高,差异均有统计学意义(均为P0.05)。术后3个月,康柏西普组18眼(69.23%)视力提高2行以上;光凝组8眼(33.33%)视力提高2行以上。治疗前2组患者的CMT组间比较,差异无统计学意义(P0.05)。康柏西普组和光凝组治疗后1周、1个月、2个月、3个月时CMT均较术前减小,差异均有统计学意义(均为P0.05)。康柏西普组与光凝组治疗后1周、1个月、2个月、3个月时2组间CMT比较均较小,差异均有统计学意义(均为P0.05)。康柏西普组首次注药后随访3个月,11眼行重复注射。其中1个月后CMT250μm重复注射2眼,2个月后重复注射7眼,3个月后重复注射2眼。随访期间50眼均未发生与药物、玻璃体内注射相关的全身不良反应。注射后出现局部球结膜下出血7眼。结论康柏西普治疗BRVO继发的非缺血性黄斑水肿术后视力提高的程度和黄斑区视网膜水肿减轻的程度均优于黄斑区格栅样光凝治疗。
[Abstract]:Objective to investigate the efficacy and safety of intravitreous injection of Compactopril and macular photocoagulation in the treatment of non ischemic macular edema secondary to retinal branch vein occlusion (branch retinal vein occlusion,BRVO). Methods 50 patients (50 eyes) with non-ischemic macular edema secondary to BRVO were retrospectively analyzed. According to the operation conditions, the patients were divided into two groups: 26 patients (26 eyes) in the Compactopril group received intravitreous injection on demand. 24 patients (24 eyes) in the photocoagulation group were treated with standard macular area grid photocoagulation for macular edema. The best corrected visual acuity (best-corrected visual acuity,) was observed at 1 week, 1 month, 2 months and 3 months after operation in both groups. BCVA) and macular foveal thickness (central macular thickness,CMT). The changes of BCVA,CMT were compared before and after treatment, and the occurrence of ocular and systemic complications were observed. Results there was no significant difference in BCVA between the two groups before treatment (P0.05). After 1 week, 1 month, 2 months and 3 months after treatment, the BCVA in Compactopril group and photocoagulation group were significantly higher than those before treatment (P0.05). There were significant differences between the two groups at 1 week, 1 month, 2 months and 3 months after treatment (P0.05). After 3 months, the visual acuity of 18 eyes (69.23%) and 8 eyes (33.33%) were improved by more than 2 lines in Compactopril group and photocoagulation group respectively. There was no significant difference in CMT between the two groups before treatment (P0.05). After 1 week, 1 month, 2 months and 3 months after treatment, the CMT of Compactopril group and photocoagulation group were significantly lower than that of preoperative treatment (P0.05). After 1 week, 1 month, 2 months and 3 months after treatment, the difference of CMT between the two groups was statistically significant (P0.05). Three months after the first injection, 11 eyes in the Compactopril group were treated with repeated injection. CMT250 渭 m was injected repeatedly in 2 eyes 1 month later, 7 eyes 2 months later and 2 eyes 3 months later. There were no systemic adverse reactions associated with intravitreous injection in 50 eyes during follow-up. Local subconjunctival hemorrhage occurred in 7 eyes after injection. Conclusion the degree of visual acuity improvement and retinal edema relief in macular area treated with Compactopril in patients with non ischemic macular edema secondary to BRVO are better than those in macular area grid like photocoagulation.
【作者单位】：首都医科大学附属北京安贞医院眼科;
【基金】：首都医科大学附属北京安贞医院院长科技发展基金(编号:2013F03)~~
【分类号】：R774.5

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