康柏西普治疗非缺血型视网膜静脉阻塞黄斑水肿疗效的影响因素研究
发布时间：2018-12-10 19:26
【摘要】：目的:1观察玻璃体腔内注射康柏西普治疗非缺血型视网膜静脉阻塞合并黄斑水肿的短期临床疗效及安全性。2探求玻璃体腔内注射康柏西普治疗非缺血型视网膜静脉阻塞合并黄斑水肿疗效的影响因素。方法:前瞻性研究,选取2015年1月至2016年9月从出现自觉症状到就诊病程小于12个月的在我院眼科就诊的病例,经过眼底检查和眼底荧光血管造影确诊为非缺血型视网膜静脉阻塞合并黄斑水肿的患者。OCT检查重点关注视网膜厚度和内部结构。在患者选择和签署知情同意后,玻璃体腔内注射康柏西普,三组均先注射1次,随访时根据视力和OCT检查变化,重复注射。治疗前和治疗后1、2、3、6个月常规检查裂隙灯、眼底镜、BCVA、OCT、眼压变化以及末次随访时每只眼的总注射次数情况。应用SPSS 21.0统计学软件进行统计学分析。治疗前后视力及CMT变化比较懫用t检验。P0.05为差异有统计学意义。结果:共37例37只眼纳入研究,男性19人,女性18人。年龄23-73岁。37只眼最佳视力(Log MAR值)0.2,最差视力(Log MAR值)1,平均0.52±0.18;黄斑囊样水肿的囊泡高度最小为257μm,最大为873μm,平均(474.92±125.48)μm。按照性别、年龄、病程长短、初始视力高低及初始黄斑水肿高度的不同,依次分组进行研究1性别性别与视力预后疗效无统计学意义。2年龄年龄与视力预后疗效无统计学意义。3初诊视力初诊视力与视力预后疗效有统计学意义(P值均0.05)。4初诊黄斑水肿高度初诊黄斑水肿高度与视力预后疗效有统计学意义(P值均0.05)。5.1最佳矫正视力A、B、C三组治疗前的BCVA与治疗后各时间点BCVA比较,各组BCVA均有明显的好转,差异均有统计学意义(P10.05;P20.05;P30.05)。5.2黄斑中心厚度A、B、C三组治疗前患者的CMT与治疗后各时间点CMT比较,各组CMT均有明显降低,差异均有统计学意义(P10.05;P20.05;P30.05)。5.3治疗前后最佳矫正视力差值A、B、C三组患者BCVA治疗前与治疗后1个月、3个月及6个月的差值分别为0.32±0.12、0.32±0.13及0.37±0.11;0.38±0.13、0.42±0.17及0.44±0.13;0.21±0.16、0.20±0.12及0.22±0.15。三组间治疗后1个月、3个月及6个月BCVA的差值的对比,差异有统计学意义(F=5.10,6.81,7.89;P0.05)。5.4治疗前后黄斑中心厚度差值A、B、C三组患者CMT治疗前与治疗后1个月、3个月及6个月的差值分别为(249.86±141.57)μm、(248.14±138.43)μm及(258.00±139.91)μm;(294.64±130.03)μm、(297.00±136.50)μm及(300.18±138.52)μm;(248.33±83.85)μm、(255.75±83.84)μm及(256.08±84.16)μm。三组间治疗后1个月、3个月及6个月CMT的差值的对比,差异无统计学意义(F=0.537,0.539,0.466;P0.05)。5.5治疗次数在6个月内,早期治疗组(A组)的注射次数为2.29±1.27,中期治疗组(B组)的注射次数为2.55±0.68,晚期治疗组(C组)的注射次数为2.92±1.00,三者间的差异无统计学意义(P0.05)。5.6眼压与治疗前的眼压相比较,三组内的各随访点均没有统计学差异。不仅如此,三组间各随访时间点的眼压比较也没有统计学差异。在随访期间均未观察到高眼压、眼内炎、玻璃体积血及视网膜脱离等眼部并发症以及严重的全身不良反应。结论:1玻璃体腔内注射康柏西普治疗非缺血型RVO安全有效,短期内能有效改善ME,进而提高患者的视力。2病程的长短、初诊时视力的水平及初诊时黄斑水肿高度的水平是影响RVO-ME疗效的主要因素。
[Abstract]:Objective: To observe the short-term clinical efficacy and safety of the treatment of non-ischemic retinal vein occlusion combined with macular edema in vitreous cavity. Methods: A prospective study was conducted to select the cases of patients with macular edema with non-ischemic retinal vein occlusion by fundus examination and fundus fluorescein angiography from January 2015 to September 2016. The OCT examination focused on the thickness and internal structure of the retina. After the patient selected and signed the informed consent, the vitreous cavity was injected with the conifera and the three groups were first injected once, and at the follow-up, the injection was repeated according to the visual acuity and the OCT examination. The total number of injections per eye at 1, 2, 3 and 6 months before and after treatment, fundus, BCVA, OCT, IOP change, and end-time follow-up. The statistical analysis was performed using the SPSS 26.0 statistical software. The visual and CMT changes before and after treatment were compared with t-test. The difference of P0. 05 was of statistical significance. Results: 37 cases of 37 eyes were included in the study, 19 males and 18 females. Age 23-73 years. 37-eye best vision (Log MAR value) 0. 2, worst-case vision (Log MAR value) 1, mean 0.52-0.18; the vesicle height of macular edema was at least 257. m u.m, the maximum was 873. m u.m, and the average (474.92-125.48). m the initial visual acuity and the initial macular edema height are different, There was no significant difference in the efficacy of gender and visual outcome in the first group. The results of the first diagnosis of visual acuity and the prognosis of visual acuity were of statistical significance (P <0.05). The height of macular edema in the first diagnosis of macular edema was the same as that of the first diagnosis. The results of visual prognosis were statistically significant (P <0.05). The BCVA of the best corrected visual acuity A, B and C in the first group was compared with the BCVA at all time points after treatment. There was a significant improvement in BCVA in each group. The difference was statistically significant (P10.05; P20.05; P3.0. 05). The thickness of the macula was A, B, The results showed that the CMTs of the patients before and after treatment were significantly lower than that of the CMT and the time-point CMT after treatment (P10.05; P20.05; P30. 05). The best corrected corrected visual acuity was A and B before and after the treatment. The difference of BCVA before and after treatment in three groups was 0.32, 0.12, 0.32, 0.13, 0.37, 0.11, 0.38, 0.13, 0.42, 0.17 and 0.44, 0.13, 0.21, 0.16, 0.20, 0.12 and 0.22, 0.15, respectively. The difference of BCVA between 3 and 6 months after treatment was statistically significant (F = 5.10, 6.81, 7.89; P0.05). (248. 14-138.43). mu.m and (258.00-139.91). mu.m; (294.64-133.03). mu.m, (297.00-136.50). mu.m and (300,18-138.52). mu.m, (248.33-83.85). mu.m, (255.75-83.84). mu.m, and (258.08-84.16). mu.m. The number of injections in the early treatment group (group A) was 2.29 to 1.27 in the early treatment group (group A) and 2.92 to 1.00 in the late treatment group (group C). The difference between the three groups was not significant (P0.05). In addition, there was no statistically significant difference in the IOP between the three groups of follow-up time points. No ocular complications such as high intraocular pressure, endophthalmitis, vitreous hemorrhage and retinal detachment were observed during the follow-up period, as well as serious systemic adverse reactions. Conclusion: The treatment of non-ischemic RVO is safe and effective in 1 glass body cavity, and it is effective to improve the visual acuity of patients in the short term. The duration of the course, the level of visual acuity at the first visit and the level of macular edema at the first visit are the main factors that affect the efficacy of the RVO-ME.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R774
本文编号：2371081
[Abstract]:Objective: To observe the short-term clinical efficacy and safety of the treatment of non-ischemic retinal vein occlusion combined with macular edema in vitreous cavity. Methods: A prospective study was conducted to select the cases of patients with macular edema with non-ischemic retinal vein occlusion by fundus examination and fundus fluorescein angiography from January 2015 to September 2016. The OCT examination focused on the thickness and internal structure of the retina. After the patient selected and signed the informed consent, the vitreous cavity was injected with the conifera and the three groups were first injected once, and at the follow-up, the injection was repeated according to the visual acuity and the OCT examination. The total number of injections per eye at 1, 2, 3 and 6 months before and after treatment, fundus, BCVA, OCT, IOP change, and end-time follow-up. The statistical analysis was performed using the SPSS 26.0 statistical software. The visual and CMT changes before and after treatment were compared with t-test. The difference of P0. 05 was of statistical significance. Results: 37 cases of 37 eyes were included in the study, 19 males and 18 females. Age 23-73 years. 37-eye best vision (Log MAR value) 0. 2, worst-case vision (Log MAR value) 1, mean 0.52-0.18; the vesicle height of macular edema was at least 257. m u.m, the maximum was 873. m u.m, and the average (474.92-125.48). m the initial visual acuity and the initial macular edema height are different, There was no significant difference in the efficacy of gender and visual outcome in the first group. The results of the first diagnosis of visual acuity and the prognosis of visual acuity were of statistical significance (P <0.05). The height of macular edema in the first diagnosis of macular edema was the same as that of the first diagnosis. The results of visual prognosis were statistically significant (P <0.05). The BCVA of the best corrected visual acuity A, B and C in the first group was compared with the BCVA at all time points after treatment. There was a significant improvement in BCVA in each group. The difference was statistically significant (P10.05; P20.05; P3.0. 05). The thickness of the macula was A, B, The results showed that the CMTs of the patients before and after treatment were significantly lower than that of the CMT and the time-point CMT after treatment (P10.05; P20.05; P30. 05). The best corrected corrected visual acuity was A and B before and after the treatment. The difference of BCVA before and after treatment in three groups was 0.32, 0.12, 0.32, 0.13, 0.37, 0.11, 0.38, 0.13, 0.42, 0.17 and 0.44, 0.13, 0.21, 0.16, 0.20, 0.12 and 0.22, 0.15, respectively. The difference of BCVA between 3 and 6 months after treatment was statistically significant (F = 5.10, 6.81, 7.89; P0.05). (248. 14-138.43). mu.m and (258.00-139.91). mu.m; (294.64-133.03). mu.m, (297.00-136.50). mu.m and (300,18-138.52). mu.m, (248.33-83.85). mu.m, (255.75-83.84). mu.m, and (258.08-84.16). mu.m. The number of injections in the early treatment group (group A) was 2.29 to 1.27 in the early treatment group (group A) and 2.92 to 1.00 in the late treatment group (group C). The difference between the three groups was not significant (P0.05). In addition, there was no statistically significant difference in the IOP between the three groups of follow-up time points. No ocular complications such as high intraocular pressure, endophthalmitis, vitreous hemorrhage and retinal detachment were observed during the follow-up period, as well as serious systemic adverse reactions. Conclusion: The treatment of non-ischemic RVO is safe and effective in 1 glass body cavity, and it is effective to improve the visual acuity of patients in the short term. The duration of the course, the level of visual acuity at the first visit and the level of macular edema at the first visit are the main factors that affect the efficacy of the RVO-ME.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R774
【参考文献】
相关期刊论文 前9条
1 高晶;原艳波;解瑞;于娟;高玉娟;郭倩;;玻璃体腔内注射雷珠单抗治疗非缺血型视网膜中央静脉阻塞继发黄斑水肿的临床观察[J];中华眼科医学杂志(电子版);2016年04期
2 王春明;冯宇梁;李佳;张明;俞德超;;年龄相关性黄斑变性治疗药物研究进展及未来研发方向[J];眼科新进展;2015年06期
3 韩姬;王玲;刘伟仙;孙宏亮;蔡维;;康柏西普玻璃体腔注射对糖尿病视网膜病变患者视力的影响[J];中国全科医学;2015年05期
4 李常栋;朱国伟;李琳;郭乔茜;陈雪艺;;球周注射曲安奈德对兔眼周围组织的影响[J];中华实验眼科杂志;2014年03期
5 孟晓丽;冯俊;;视网膜分支静脉阻塞黄斑水肿的研究概况[J];中国中医眼科杂志;2014年01期
6 丁小燕;李加青;于珊珊;吴斌斌;曾婧;刘冉;潘间英;唐仕波;;贝伐单抗治疗视网膜中央静脉阻塞黄斑水肿后视力恢复的预测因素分析[J];中山大学学报(医学科学版);2012年01期
7 骆新瑞;郑钦象;李文生;;视网膜中央静脉阻塞的循证医学研究进展[J];中国实用眼科杂志;2011年02期
8 陈萍;血塞通治疗视网膜静脉阻塞46例疗效观察[J];中原医刊;2003年23期
9 张惠蓉,夏英杰;视网膜静脉阻塞患者视力预后相关因素分析[J];中华眼科杂志;2002年02期
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