玻璃体内注射雷珠单抗治疗老年黄斑变性合并视网膜中央静脉阻塞的疗效

发布时间：2018-06-26 11:11

本文选题：玻璃体内注射雷珠单抗 + 黄斑变性　；参考：《中国老年学杂志》2014年23期

【摘要】：目的探讨玻璃体内注射雷珠单抗治疗老年黄斑变性合并视网膜中央静脉阻塞的疗效。方法将2012年1月至2013年9月该院收治的老年黄斑变性合并视网膜中央静脉阻塞患者62例62眼随机分为观察组和对照组,每组31例31眼。对照组接受视网膜光凝治疗。观察组每月玻璃体内注射雷珠单抗0.5 mg,1次/月,连续治疗3个月。统计分析两组治疗期间和治疗后半年内的最佳矫正视力、眼压、黄斑中心凹厚度(CMT)、眼底荧光血管造影(FFA)黄斑区荧光渗漏和并发症发生情况。结果观察组治疗前最佳矫正视力为3.32±0.58,低于治疗1、2 w、1、2、3个月及治疗后1、3、6个月的3.58±0.67,3.65±0.62,3.68±0.66,3.71±0.95,3.76±0.73,3.79±0.75,3.80±0.77和3.81±0.65;对照组治疗1、2、3个月及治疗后1、3、6个月的最佳矫正视力亦高于治疗前,且治疗2个月和3个月及治疗后1、3、6个月观察组最佳矫正视力均高于对照组;治疗2 w内两组患者的眼压出现升高后逐渐下降和CMT变薄,且治疗2个月和3个月及治疗后1、3、6个月观察组眼压均低于对照组,CMT亦较对照组薄(P0.05)。两组治疗后FFA黄斑区荧光渗漏情况均得以改善,且观察组无明显渗漏的患者比例较对照组升高(P0.05)。两组结膜下出血、视网膜脱离、细菌性眼炎等并发症的总发生率均为9.38%,两者无差异(P0.05)。结论玻璃体内注射雷珠单抗治疗老年黄斑变性合并视网膜中央静脉阻塞可有效提高患者视力、控制眼压、促进黄斑消退和视网膜出血的吸收且不会明显增加并发症的发生,具有良好的可行性和安全性,值得推广用。
[Abstract]:Objective to evaluate the efficacy of intravitreal injection of Lei Zhu McAb in the treatment of senile macular degeneration with central retinal vein occlusion. Methods from January 2012 to September 2013, 62 cases (62 eyes) of senile macular degeneration complicated with central retinal vein occlusion were randomly divided into observation group (n = 31) and control group (n = 31). The control group was treated with retinal photocoagulation. In the observation group, intravitreous injection of 0.5 mg / month of Leizhu McAb was performed once a month for 3 months. The best corrected visual acuity intraocular pressure (IOP) central foveal thickness (CMT) fundus fluorescein angiography (FFA) macular leakage and complications were analyzed statistically. Results the best corrected visual acuity before treatment in the observation group was 3.32 卤0.58, which was lower than that in the control group, which was lower than that in the control group at 1 w2, 3 months and 1 day after treatment, and the best corrected visual acuity in the control group was also higher than that in the control group at 1 month, 3 months and 1 month after treatment, and the best corrected visual acuity in the control group was also higher than that in the control group at 1 month, 3 months and 1 month after treatment, and the best corrected visual acuity in the observation group was 3.58 卤0.67 卤0.67 卤0.76 卤0.753.79 卤0.753.80 卤0.77 and 3.81 卤0.65 respectively. The best corrected visual acuity (BCVA) in the observation group was higher than that in the control group after 2 months and 3 months and 1 and 6 months after treatment, and the IOP of the two groups gradually decreased and the CMT thinned after 2 weeks of treatment. The IOP of the observation group was lower than that of the control group at 2 and 3 months and 1 and 6 months after treatment (P0.05). The fluorescence leakage in the macular area of FFA was improved in both groups after treatment, and the proportion of patients without obvious leakage in the observation group was higher than that in the control group (P0.05). The total incidence of complications such as subconjunctival hemorrhage, retinal detachment and bacterial ophthalmitis was 9.38 in the two groups, and there was no difference between the two groups (P0.05). Conclusion intravitreal injection of Lei Zhu McAb in the treatment of senile macular degeneration with central retinal vein occlusion can effectively improve the visual acuity, control intraocular pressure, promote the absorption of macular regression and retinal hemorrhage without significantly increasing the incidence of complications. It has good feasibility and safety, and is worth popularizing.
【作者单位】：南阳市中心医院眼科;
【分类号】：R774.1

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