血栓通离子导入联合康柏西普玻璃体腔注射治疗视网膜静脉阻塞合并黄斑水肿

目的：研究血栓通离子导入联合康柏西普玻璃体腔注射治疗视网膜静脉阻塞(RVO)合并黄斑水肿(ME)的临床效果及安全性。

方法：前瞻性研究。将2017-06/2019-06我院106例106眼RVO合并ME患者采用随机数字表法均分为观察组和对照组各53例53眼，均给予玻璃体腔注射康柏西普进行治疗； 观察组另加用血栓通注射液离子导入进行干预，用药时间3mo，两组均随访1a并根据病情进行补充治疗，观察并比较两组治疗前后最佳矫正视力(BCVA)、黄斑区中央视网膜厚度(CRT)、补充治疗情况、房水血管内皮生长因子(VEGF)水平及药物不良反应。

结果：两组治疗后BCVA明显改善(P<0.05)，CRT明显降低(P<0.05)，且观察组治疗3、6、12mo BCVA高于对照组，CRT低于对照组(P<0.05)； 两组治疗后黄斑总容积和房水VEGF水平均明显降低(P<0.05)，且观察组治疗1、3、6、12mo黄斑总容积和VEGF水平低于对照组(均P<0.05)； 观察组康柏西普、曲安奈德注射次数和激光光凝患者占比均低于对照组(P<0.05)； 观察组治疗期间发生眼压升高1眼、结膜下出血3眼，对照组发生结膜下出血2眼、眼内炎1眼，两组比较无差异(P>0.05)。

结论：血栓通离子导入联合康柏西普玻璃体腔注射治疗RVO合并ME可有效抑制VEGF表达，减轻ME并改善患眼视力，疗效和安全性均值得肯定。

Efficacy of anti-VEGF therapy combined with iontophoresis of Xueshuantong injection on retinal vein obstruction with macular edema

AIM: To study the clinical effects and safety of iontophoresis of xueshuantong injection combined with anti-vascular endothelial growth factor(VEGF)in the treatment of retinal vein occlusion(RVO)with macular edema(ME).

METHODS: Totally 106 patients(106 eyes)with RVO and ME in the hospital between June 2017 and June 2019 were divided into observation group and control group according to the random number table method with 53 cases(53 eyes)in each group, and they were all given intravitreal injection of conbercept, and observation group was additionally given iontophoresis of Xueshuantong injection for intervention, and they were treated for 3mo. Both groups were followed up for 1a and given supplementary therapy according to the condition of the disease. The best corrected visual acuity(BCVA), central retinal thickness(CRT)in macular area, supplementary therapy status, VEGF level in aqueous humor and adverse drug reactions were observed and compared between the two groups before and after treatment.

RESULTS: After treatment, the BCVA of the two groups was significantly improved(P<0.05)while the CRT in macular area was significantly thinned(P<0.05), and the BCVA on the 3, 6 and 12mo of treatment in observation group was better than that in control group while the CRT was thinner than that in control group(P<0.05). The macular volume and VEGF level in aqueous humor were significantly reduced in the two groups after treatment(P<0.05), and the macular volume and VEGF level on the 1, 3, 6 and 12mo of treatment in observation group were lower than those in control group(P<0.05). The injection frequencies of conbercept and triamcinolone acetonide and the proportion of patients with laser photocoagulation in observation group were lower than those in control group(P<0.05). During treatment, there was 1 eye of intraocular pressure increase and 3 eyes of subconjunctival hemorrhage in observation group, and there were 2 eyes of subconjunctival hemorrhage and 1 eye of endophthalmitis in control group(P>0.05).

CONCLUSION: Xueshuantong iontophoresis combined with intravitreal injection of conbercept for RVO with ME can effectively inhibit the expression of VEGF, reduce the ME and improve the visual acuity of the affected eyes. The efficacy and safety are worthy of recognition.