玻璃体腔注射雷珠单抗联合GLP治疗BRVO-ME的临床观察

目的 研究视网膜分支静脉阻塞继发黄斑水肿(BRVO-ME)患者应用雷珠单抗玻璃体腔注射联合格栅样视网膜激光光凝术(GLP)治疗的临床效果。 方法 选取135例(135眼)BRVO-ME临床资料,随机分为单纯药物组(n=45)、单纯激光组(n=45)、联合治疗组(n=45),单纯药物组仅应用雷珠单抗玻璃体腔注射,单纯激光组仅应用GLP治疗,联合治疗组先予雷珠单抗玻璃体腔注射,间隔1周后应用GLP治疗。 结果 三组治疗3个月后最佳矫正视力(BCVA)水平对比,较治疗前差异有统计学意义(P<0.05),且联合治疗组治疗1、2、3个月后BCVA水平较同期单纯药物组、单纯激光组差异有统计学意义(P<0.05)。三组治疗3个月后黄斑中心凹视网膜厚度(CMT)水平对比,均较治疗前差异有统计学意义(P<0.05),且联合治疗1、2、3个月后CMT水平较同期单纯药物组、单纯激光组差异均有统计学意义(P<0.05)。 结论 玻璃体腔注射雷珠单抗联合GLP治疗BRVO-ME较单纯药物和单纯激光治疗,降低黄斑中心凹视网膜厚度、改善黄斑水肿、提高视力效果更明显,复发率更低,安全有效。

Clinical observation on the treatment of BRVO-ME by the combination of laser therapy with Ranibizumab intravitreal injection

Objective To explore the clinical efficacy of branch retinal vein occlusion secondary macular edema (BR-VO-ME) treated with Ranibizumab intravitreal injection combined with grille laser photocoagulation (GLP).Methods A total of 135 (135 eyes) BRVO-ME cases were divided into 3 groups:simple drug group (n =45),simple laser group (n =45),and combined treatment group (n =45).The simple drug group received Ranibizumab intravitreal injection only.The simple laser group received GLP only.The combined treatment group received Ranibizumab intravitreal injection first,and then GLP 1 week after.The best corrected visual acuity (BCVA),central macular thickness (CMT),and intraocular pressure (IOP) of the 3 groups were observed.Results Three months after treatment,BCVA and CMT of all groups were significantly different (P ＜ 0.05).The combined treatment group had significantly lower BCVA and CMT than the other 2 groups in postoperative month 1,2 and 3 (P ＜ 0.05).During the treatment,no increased IOP was observed (P ＞ 0.05).No postoperative infection,vitreous hemorrhage,bacterial endophthahnitis or other adverse reactions occurred.Conclusion Ranibizumab intravitreal injection combined with GLP is safe and effective in the treatment of BRVO-ME,which can reduce the CMT,relieve macular edema,and improve visual acuity.