雷珠单抗治疗视网膜分支静脉阻塞所致黄斑水肿

雷珠单抗治疗视网膜分支静脉阻塞所致黄斑水肿

周祁;毕燕龙;范斌;刘振兴;陈冉冉;付金玲;徐玉乐;隋桂琴

【期刊名称】《中华眼外伤职业眼病杂志》 【年(卷),期】2016(038)002

【摘要】Objective To observe the clinical effects of intravitreal Ranibizumab injection (IVR)for the treatment of the macular edema due to branch retinal vein occlusion.Methods Sixty seven consecutive cases eyes of 67 of the macular edema due to branch retinal vein occlusion treated by IVR (10 mg/ml,0.05 ml) were retrospectively analyzed.All the cases were divided by the following two methods.According to the time between oncome of the macular edema and the first therapy,the patients were divided into 3 groups:group 1 of less than 1 week,group 2 of 1week-3 months and group 3 of over 3 months.And according to the treating regulation,the patients were divided into 2 groups:treatment on time group and treatment on demand group.The follow-up contents included the best corrected visual acuity (BCVA,LogMAR),1 mm diameter macular central retinal thickness (CRT) and fluorescence fundus angiography (FFA).The average follow-up period was (13.2 ± 1.3) months.Results When the group division according to the time between oncome of the macular edema and the first therapy,the BCVA of the patients in group 1 was 0.131 ±0.061 and CRT was (268 ±21) μm two months after the treatment.The BCVA was 0.086 ± 0.042 and CRT was

(259 ± 19) μ m 12 months after the treatment.In group 2,the BCVA was 0.276 ± 0.112 and CRT was (321 ± 45) μm 2 months after the treatment and the BCVA was 0.292 ± 0.105 and CRT was (268 ±29) μm 12 months after the treatment.In group 3,the BCVA was 0.523 ±0.164 and CRT was (441 ± 67) μm two months after treatment,and the BCVA was 0.387 ± 0.142 and CRT was (281 ±24) μm 12 months after the treatment.When compared with the group 1,at every follow-up time point,the differences in the BCVAs were statistically significant between group 1 and group 2 (all P ＜0.01).The CRTs at 2,4,6 months after the treatment between group Ⅰ and group 3 had statistically significant differences (all P ＜0.01).When the group division according to the treatment regulation,12months after the treatment,the BCVA was 0.208 ±0.091 in the treatment on time group and was 0.387 ±0.184 in the treatment on demand group and the difference was statistically significant (t =4.35,P ＜0.01).Twelve months after the treatment,the CRT was (290 ±46) μm in the treatment on time group and was (311 ±51) μm in the treatment on demand group,and the difference was not statistically significant(t =0.98,P =0.56).Conclusion The curative effect of IVR for retinal edema due to branch retinal vein occlusion is obvious.Early and on time treatment could significantly improve the effects.%目的 观察玻璃体内注射雷珠单抗(Ranibizumab)治疗视网膜分支静脉阻塞(BRVO)继发黄斑水肿的临床效果.方法 回顾性分析BRVO继发黄斑水肿连续病例67例(67只眼),均系采

用雷珠单抗(10 mg/ml,0.05 ml)玻璃体内注射治疗.分组:按照从发病到首次治疗的时间不同分为3组,第1组,＜1周组;第2组,1周～3个月组;第3组,＞3个月组.按照治疗规律分为按时组(每4周1次共2次,之后需要时用药)和按需组(先注射1次,之后需要时用药).随访内容为:最佳矫正视力(BCVA,LogMAR视力)、黄斑区中心1 mm直径范围的厚度(CRT)、FFA.随访期12 ～ 15个月,平均(13.2±1.3)月.结果 按从发病到首次治疗时间不同分组:在第1组,治疗后2个月的BC-VA为0.131±0.061,CRT为(268±21)μm.治疗后12个月的BCVA为0.086±0.042,CRT为(259±19)μm;在第2组,治疗后2个月的BCVA为0.276 ±0.112,CRT为(321±45) μm;治疗后12个月的BCVA为0.292±0.105,CRT为(268±290) μm;在第3组,治疗后2个月的BCVA为0.523±0.164,CRT为(441±67)μm,治疗后12个月的BCVA为0.387±0.142,CRT为(281±24) μm.第1组与第2组的BCVA比较各个随访时间点差异均有统计学意义(P均＜0.01);CRT在治疗后2、4、6个月时,第1组和第3组比较差异均有统计学意义(P均＜0.01).按治疗规律分组时,治疗后12个月,按时组的BCVA为0.208±0.091,按需组的BCVA为0.387±0.184,差别有统计学意义(t=4.35,P＜0.001);按时组的CRT为(290±46) μm,按需治疗组的CRT为(311±51) μm,差别无统计学意义(t=0.98,P=0.56).结论 雷珠单抗玻璃体内注射治疗视网膜分支静脉阻塞性黄斑水肿疗效确切,发病后早期治疗和按时治疗可显著提高疗效. 【总页数】5页(91-95)

【关键词】视网膜分支静脉阻塞;黄斑水肿;雷珠单抗,玻璃体内注射;视力 【作者】周祁;毕燕龙;范斌;刘振兴;陈冉冉;付金玲;徐玉乐;隋桂琴

【作者单位】200065上海,同济大学附属同济医院眼科;200065上海,同济大学