Avastin玻璃体腔注射联合绿激光治疗缺血型视网膜中央静脉阻塞引发的黄斑水肿的疗效评估

发布时间：2018-06-27 03:58

本文选题：Avastin + 绿激光　；参考：《中国医科大学》2010年硕士论文

【摘要】： 目的评价avastin玻璃体腔内注射联合绿激光治疗缺血型视网膜中央静脉阻塞引发黄斑水肿的临床疗效。方法对于2008年10月到2009年10月收治的24例26眼依据眼底荧光血管造影(FFA)结果,被确诊为缺血型视网膜中央静脉阻塞并伴发黄斑水肿,随机分为avastin玻璃体腔内注射联合绿激光治疗组和单纯激光治疗对照组,随访6个月,随访视力、眼压、眼部情况,并行眼底照片、荧光血管造影和光学相干断层扫描(OCT)。结果 OCT检查14例患者平均黄斑区厚度术(CFT)术前为584.36±114.76um,术后1月黄斑水肿消退为11只眼,消退率为79%。术后3个月黄斑水肿消退为11只眼,消退率为79%.术后6个月黄斑水肿消退10只眼,消退率为71%。对照组中术前OCT显示黄斑中心凹厚度450-748μm(平均599μm),手术后1个月OCT显示黄斑水肿消退为4只,消退率为33%.术后3个月黄斑水肿消退为4只眼,消退率为33%.术后6个月黄斑水肿消退为3只眼,消退率为25%。(消退：OCT证实黄斑区视网膜厚度减低大于100μm；不变：OCT证实黄斑区视网膜厚度减低小于100μm).术后1个月,实验组12例14只眼中12只眼视力有提高,提高率86%,2只眼视力无变化。对照组12只眼中4只眼视力有提高,提高率33%,5只眼视力无变化,3只眼视力下降。术后视力实验组明显高于对照组(χ2=7.490,P=0.006,Fisher确切检验法)。术后3个月,实验组12例14只眼中11只眼视力有提高,提高率79%,3只眼视力无变化。对照组12只眼中4只眼视力有提高,提高率33%,5只眼视力无变化,3只眼视力下降。术后视力实验组明显高于对照]组(χ2=5.418,P=0.02,Fisher确切检验法)。术后6个月,实验组12例14只眼中10只眼视力有提高,提高率71%,4只眼视力无变化。对照组12只眼中3只眼视力有提高,提高率25%,4只眼视力无变化,5只眼视力下降。术后视力实验组明显高于对照组(χ2=5.571,P=0.018,Fisher确切检验法)。(视力提高2行是提高,1行波动是为无变化,下降1行视为无变化。)两组均无眼压升高者。所得数据均有统计学意义。结论 avastin玻璃体腔内注射联合绿激光治疗缺血型视网膜中央静脉阻塞黄斑水肿在较短的时间内比较单纯激光治疗缺血性视网膜中央静脉阻塞,更有效的提高视力,促进黄斑水肿的吸收。
[Abstract]:Objective to evaluate the clinical effect of intravitreal injection of avastin combined with green laser in the treatment of macular edema caused by ischemic central retinal vein occlusion. Methods from October 2008 to October 2009, 26 eyes of 24 patients were diagnosed as ischemic central retinal vein occlusion with macular edema according to the results of fundus fluorescein angiography (FFA). Avastin intravitreal injection combined with green laser was randomly divided into two groups. The patients were followed up for 6 months. The visual acuity, intraocular pressure, ocular conditions, fundus photographs, fluorescein angiography and optical coherence tomography (Oct) were followed up. Results the mean macular area thickness (CFT) was 584.36 卤114.76 umum before Oct in 14 patients, and macular edema subsided in 11 eyes one month after Oct, the regression rate was 79. Macular edema subsided in 11 eyes 3 months after operation, the regression rate was 79g. Macular edema disappeared in 10 eyes 6 months after operation, the regression rate was 71. In the control group, preoperative Oct showed macular fovea thickness 450-748 渭 m (mean 599 渭 m),). Oct showed macular edema subsided in 4 rats, and the regression rate was 33%. Macular edema subsided in 4 eyes 3 months after operation, and the regression rate was 33%. Macular edema subsided in 3 eyes 6 months after operation, and the regression rate was 25%. Regression: Oct confirmed macular retinal thickness reduction greater than 100 渭 m; invariant Oct confirmed macular retinal thickness reduction less than 100 渭 m). One month after operation, the visual acuity of 12 eyes of 14 eyes of 12 cases in the experimental group was improved, and the improvement rate of 86% was unchanged in 2 eyes. In the control group, the visual acuity was improved in 4 eyes in 12 eyes and the visual acuity in 3 eyes was decreased in 3 eyes. Postoperative visual acuity in the experimental group was significantly higher than that in the control group (蠂 ~ 2 / 7.490). Three months after operation, the visual acuity of 11 eyes of 12 cases (14 eyes) in the experimental group was improved, and the improvement rate was 79% (3 eyes). In the control group, the visual acuity was improved in 4 eyes in 12 eyes and the visual acuity in 3 eyes was decreased in 3 eyes. The postoperative visual acuity in the experimental group was significantly higher than that in the control group (蠂 ~ 2 = 5.418). Six months after operation, the visual acuity of 10 eyes in 14 eyes of 12 cases in the experimental group was improved, the improvement rate was 71% and 4 eyes did not change. In control group, visual acuity was improved in 3 eyes in 12 eyes, and the visual acuity was decreased in 5 eyes in 4 eyes of 25 eyes. Postoperative visual acuity in the experimental group was significantly higher than that in the control group (蠂 2 / 5.571). Visual acuity improved by 2 lines is improved by 1 row fluctuation is no change, and decreased by 1 line is regarded as no change. There was no elevation of intraocular pressure in both groups. The data were statistically significant. Conclusion avastin intravitreal injection combined with green laser in the treatment of macular edema due to ischemic central retinal vein occlusion is more effective in improving visual acuity than that in the treatment of ischemic central retinal vein occlusion in a short time. Promote the absorption of macular edema.
【学位授予单位】：中国医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R774.5

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