玻璃体内注射雷珠单抗与曲安奈德治疗视网膜静脉阻塞继发黄斑囊样水肿的疗效比较

目的：比较玻璃体内注射雷珠单抗与曲安奈德治疗视网膜静脉阻塞（ retinal vein occlusion ，RVO）继发黄斑囊样水肿（ cystoidmacular edema ，CME）的疗效及安全性。方法97例RVO继发CME患者按治疗方法分为雷珠单抗组（n＝47）和曲安奈德组（n＝50）。雷珠单抗组给予玻璃体内注射雷珠单抗0．5 mg（0．05 ml）；曲安奈德组给予玻璃体内注射雷珠单抗4．0 mg（0．1 ml）。治疗后随访6个月，比较2组最佳矫正视力（best corrected visual acuity，BC－VA）、黄斑中心凹厚度（ central macular thickness ，CMT）、眼压及并发症发生率。结果2组治疗后各时间点BCVA均较治疗前显著提高（P＜0．05），但2组间比较差异无统计学意义（P＞0．05）。2组治疗后各时间点CMT均较治疗前显著降低（P＜0．05），但2组间比较差异无统计学意义（P＞0．05）。雷珠单抗组治疗后各时间点眼压与治疗前比较差异无统计学意义（ P＞0．05）；曲安奈德组治疗后各时间点眼压均较治疗前和雷珠单抗组显著提高（ P＜0．05）。曲安奈德组和雷珠单抗组眼压升高发生率比较，差异有统计学意义（P＜0．05）。结论玻璃体内注射雷珠单抗治疗RVO继发CME，可有效提高BCVA、降低CMT，其效果与曲安奈德相当，且安全性更高。

Comparison of the therapeutic effects between ranibizumab intravitreal injection and triamcinolone acetonide on cystoid macular edema due to retinal vein occlusion

Objective To investigate the therapeutic effects and safety of ranibizumab intravitreal injection and triamcinolone acetonide on cystoid macular edema (CME) due to retinal vein occlusion (RVO).Methods Ninety-seven patients with CME due to RVO were divided into two groups according to different therapeutic methods , the 47 patients in ranibizumab group were treated with ranibizumab 0.5mg (0.05ml) by intravitreal injection,however,the 50 patients in triamcinolone acetonide group were treated with triamcinolone acetonide 4.0mg ( 0.1ml ) by intravitreal injection .After treatment, the patients were followed up for 6 months, the best corrected visual acuity ( BCVA),central macular thickness (CMT),intraocular pressure and incidence rates of complications were observed and compared between two groups .Results After treatment the BCVA in different time points was significantly increased in both groups , as compared with that before treatment ( P <0.05), however,there was no significant difference between two groups ( P <0.05).After treatment the CMT in different time points was significantly decreased in both groups ,as compared with that before treatment ( P <0.05), however,there was no significant difference between two groups ( P <0.05 ).There was no significant difference in intraocular pressure of ranibizumab group in different time points after treatment and before treatment ( P >0.05).However the intraocular pressure in triamcinolone acetonide group in different time points were significantly increased after treatment ,as compared with that before treatment and that in ranibizumab group ( P <0.05).Besides there were significant differences in the incidence rates of intraocular pressure increasing between two groups ( P <0.05).Conclusion The intravitreal injection with ranibizuma in treatment of cystoid macular edema due to retinal vein occlusion can effectively increase BCVA ,decrease CMT, its therapeutic effects are similar to those of triamcinolone acetonide , moreover, its safety is better than that of triamcinolone acetonide .