玻璃体腔注射 Ranibizumab联合视网膜光凝治疗视网膜分支静脉阻塞继发黄斑水肿

摘要

目的：观察玻璃体腔注射Ranibizumab(雷珠单抗)联合视网膜光凝术对视网膜分支静脉阻塞( branch retinal vein occlusion,BRVO)继发黄斑水肿的治疗效果。n　　方法：确诊为视网膜分支静脉阻塞继发性黄斑水肿的患者42例42眼,随机分为三组,每组14眼。单纯注药组给予玻璃体腔注射Ranibizumab 0.05 mL；单纯光凝组行黄斑格栅样光凝；联合治疗组先行玻璃体腔内注射Ranibizumab,再于注药1wk 后行黄斑格栅样光凝。观察三组治疗前和治疗后1,3,6 mo时患者的最佳矫正视力( BCVA)、黄斑区中心凹厚度( CMT)。n　　结果：三组在治疗前BCVA和CMT组间差异无显著性( P>0.05)。各组在治疗后1,3,6 mo的BCVA和CMT均优于治疗前,差异有统计学意义(P<0.05)。单纯注药组治疗后1,3,6mo 的 BCVA 和 CMT 变化有显著性差异( P<0.05),BCVA呈下降趋势,CMT呈增厚趋势；单纯光凝组和联合治疗组治疗后1,3,6 mo BCVA及CMT变化无显著性差异(P>0.05)。治疗后1,3,6mo,联合治疗组BCVA和CMT优于单纯注药组和单纯光凝组(P<0.05),治疗后3,6 mo,单纯光凝组BCVA和CMT优于单纯注药组(P<0.05)。n　　结论：玻璃体腔注射Ranibizumab联合视网膜光凝可以有效治疗视网膜分支静脉阻塞继发黄斑水肿,提高视力,相比单纯注药或者单纯光凝效果更稳定可靠。%AIM: To evaluate the clinical therapeutic efficacy of intravitreal ranibizumab injection combined grid laser photocoagulation for macular edema secondary to branch retinal vein occlusion ( BRVO) . n METHODS:Forty-two confirmed cases (42 eyes) with macular edema secondary to BRVO were randomized into 3 groups, each group contained 14 eyes. The ranibizumab group was received intravitreal injection of ranibizumab (0. 05mL), the laser group was received grid laser photocoagulation, and the combined group was received a second therapy of grid laser photocoagulation after 1wk of the intravitreal injection of ranibizumab. Recorded the best-corrected visual acuity ( BCVA ) and the central macular thickness ( CMT ) preoperative and at 1, 3, 6mo after therapy. n RESULTS: The BCVA and the CMT had no differences among three groups pretherapy (P>0. 05). While BCVA was much better and CMT was reduced significantly posttherapy than pretherapy in all three groups ( P<0.05 ) . The BCVA and CMT in the ranibizumab group were significantly different in every time point ( 1, 3, 6mo) (P<0. 05). The BCVA declined and the CMT was thicker as the time went on. In the laser group and the combined group, BCVA and CMT had little differences in different time point ( P>0. 05 ). While the BCVA was better and the CMT was thinner in the combined group than ranibizumab group and laser group at every time point (P<0. 05). At 3 and 6mo, the BCVA was better and the CMT was thinner in laser group than Ranibizumab group (P<0. 05). n CONCLUSION: The intravitreal ranibizumab injection combined grid laser photocoagulation is an effective treatment method for the macular edema secondary to BRVO, it is more effective in improving BCVA than intravitreal ranibizumab or grid laser photocoagulation alone.