膜剥离联合玻璃体腔注射贝伐单抗治疗黄斑前膜

发布时间：2018-01-25 19:45

本文关键词： 黄斑病变玻璃体手术光学相干断层成像术　出处：《南方医科大学学报》2014年08期 　论文类型：期刊论文

【摘要】：目的探讨膜剥离联合玻璃体腔注射贝伐单抗治疗黄斑前膜的临床效果。方法回顾性,对照研究。2012年1月~2013年6月选取进行玻璃体手术膜剥离治疗黄斑前膜患者33例(33只眼),随机分为玻璃体腔注射贝伐单抗组(IVB组)和非玻璃体腔注射贝伐单抗组(非IVB组)。所有患者均行标准三切口玻璃体切除,剥除黄斑前膜,IVB组手术结束时玻璃体腔注入贝伐单抗1.5 mg。患者治疗前后均进行最佳矫正视力、光相干断层成像术检查(optical coherence tomography,OCT)检查。术后随访3~14个月(平均6.5个月)。收集两组数据,应用SPSS17.0进行统计学分析。结果黄斑前膜均经手术成功剥除,未见眼内感染、出血等并发症。15只眼进行了玻璃体手术膜剥离联合玻璃体腔贝伐单注射术,18只眼进行了玻璃体手术膜剥离。随访毕,最佳矫正视力变化IVB组视力提高者11只眼,约占73.3%,非IVB组视力提高者13只眼,约占72.2%,两组比较差异无统计学意义(P=0.627);中心凹处黄斑厚度变化,IVB组平均降低143±62μm,非IVB组平均降低96±28μm,两组比较差异有统计学意义(t=5.564,P0.01)。结论玻璃体手术膜剥离联合玻璃体腔注射贝伐单抗有助于黄斑形态结构恢复,但对视功能改善效果不明显,其在临床推广运用有待于长期大样本随机对照研究。
[Abstract]:Objective to investigate the clinical effect of membrane dissection combined with intravitreal injection of bevacizumab in the treatment of macular premembrane. From January 2012 to June 2013, 33 eyes of 33 patients with macular membrane were treated with vitreous membrane dissection. They were randomly divided into two groups: vitreous injection of bevacizumab group (IVB group) and non-vitreous injection of bevacizumab group (non-vitreous group). All patients were treated with standard three-incision vitrectomy and exfoliation of macular membrane. In IVB group, bevacizumab was injected into vitreous cavity at the end of operation. The best corrected visual acuity was obtained before and after treatment. Optical coherence tomography was examined by optical coherence tomography. The data of the two groups were collected and analyzed statistically by SPSS17.0. Results the macular membrane was removed successfully after operation. No intraocular infection, hemorrhage and other complications were observed in 15 eyes. Vitreous membrane dissection was performed in 18 eyes. The best corrected visual acuity (BCVA) was improved in 11 eyes (73.3%) in IVB group and in 13 eyes (72.2%) in non-#en1# group. There was no statistical difference between the two groups. The macular thickness at fovea was decreased by 143 卤62 渭 m in IVB group and 96 卤28 渭 m in non IVB group. The difference between the two groups was statistically significant. Conclusion vitreous membrane dissection combined with intravitreal injection of bevacizumab is helpful to the recovery of macular morphologic structure, but the effect on visual function is not obvious. Its application in clinical application needs to be used in long-term large-sample randomized controlled study.
【作者单位】：梅州市梅江区西郊街道西郊社区卫生服务中心;暨南大学第二临床医学院深圳市眼科医院;
【基金】：深圳市国际合作项目(GJHZ20120618115256900)
【分类号】：R774.5
【正文快照】： 黄斑前膜是黄斑区及其附近的视网膜前无血管的纤维组织膜,其收缩可引起视网膜皱褶、血管扭曲及牵引性黄斑水肿而严重影响视功能,分特发性和继发性两种[1-2]。本病目前无有效的药物治疗,玻璃体手术膜剥离是目前治疗黄斑前膜的有效手段[3]。膜剥离对解除牵引、恢复黄斑结构的疗

【参考文献】