玻璃体腔注射雷珠单抗联合激光治疗视网膜分支静脉阻塞

摘要

目的：观察玻璃体腔注射雷珠单抗联合黄斑区格栅样光凝治疗视网膜分支静脉阻塞（ branch retinal vein occlusion BRVO）继发黄斑水肿的疗效和安全性。　　方法：据荧光素眼底血管造影（ FFA）对30例30眼视网膜分支静脉阻塞继发黄斑水肿患者随机分为2组：第1组（14眼）单纯行黄斑区格栅样光凝（ GLP）；第2组（16眼）玻璃体腔连续注射3次雷珠单抗0．05mL/（0．5mg），每次间隔1mo，第1次注射雷珠单抗7d后行GLP治疗。随访6mo，观察最佳矫正视力（ BCVA）及光学相关断层扫描（ OCT）检查黄斑中心凹厚度（ CMT）的变化。　　结果：治疗6 mo后两组患者最佳矫正视力（ BCVA ）均提高，联合治疗组优于单纯GLP组（ P＜0．05）。 OCT显示第1组黄斑中心凹厚度平均降低236．4±113．0μm，第2组平均降低386．6±195．5μm，联合治疗组优于单纯GLP组（P＜0.05）。　　结论：联合治疗的效果明显优于单纯GLP治疗的效果，玻璃体腔内注射雷珠单抗联合黄斑区格栅样光凝术治疗视网膜分支静脉阻塞继发黄斑水肿安全有效。%AIM: To compare the safety and efficacy of intravitreal injection with ranibizumab combined with grid laser photocoagulation for the treatment of macular edema secondary to branch retinal vein occlusion ( BRVO) . METHODS: Thirty patients ( 30 eyes ) with BRVO were randomized into two groups:Group 1 (14 eyes) received grid laser photocoagulation ( GLP ) treatment alone, Group 2 (16 eyes) received three loading doses 0.05mL/(0.5mg ) of intravitreal injection with ranibizumab at monthly interval ( i.e.0, 1 month and 2 months ) plus standard laser treatment 7d after the 1st injection.During the 6 months of follow-up, observation was made on the changes of the best-corrected visual acuity ( BCVA) and central macular thickness ( CMT) by OCT. RESULTS: After 6 months follow-up, the patients'BCVA in two groups were both improved with the combined treatment group better than the simple GLP group ( P<0.05 ); OCT display that CMT of group 1 decreased by an average of 236.4 ±113.0μm, CMT of group 2 decreased by an average of 386.6 ±195.5μm with the combined treatment group better than the simple GLP group (P<0.05). CONCLUSION:The effect of the combined treatment is better than that of the simple GLP treatment.Intravitreal injection with ranibizumab combined with grid laser photocoagulation for the treatment of macular edema secondary to branch retinal vein occlusion is effective and safe.