视网膜激光光凝联合抗VEGF药物治疗视网膜静脉阻塞疾病的疗效观察

目的观察单纯视网膜光凝术和全视网膜光凝联合玻璃体腔内注射康柏西普对视网膜中央静脉阻塞伴黄斑水肿患者的疗效。方法选取2016年1月～2018年12月就诊于上海市浦东医院眼科的患有视网膜中央静脉阻塞且伴有黄斑水肿的病例共60例,随机分为两组,单纯激光组及激光联合抗VEGF药物治疗组(联合组),每组30例。两组患者均无青光眼白内障等其他眼部疾病,且眼底状况无显著差异。联合组先行玻璃体腔内注射康柏西普,1周后再行无灌注区光凝,单纯激光组患者分次行无灌注区光凝及黄斑区标准的格栅状光凝治疗,观察单纯激光组与联合组在治疗前及治疗后的最佳矫正视力、眼底及OCT的对比变化情况。结果治疗后两组BCVA均较治疗前提高而CMT均较治疗前降低,差异均有统计学意义(P0.05);联合组与单纯激光组比较发现联合组效果优于单纯激光组,差异均有统计学意义(P0.05)。结论激光联合抗VEGF药物治疗视网膜静脉阻塞伴黄斑囊样水肿,可有效改善黄斑区视网膜厚度及最佳矫正视力,恢复视功能。

Therapeutic effect of retinal laser photocoagulation combined with anti-VEGF drugs in the treatment of retinal vein occlusion

Objective To observe the efficacy of simpleretinal photocoagulation and retinal photocoagulation combined with intravitreal injection of compaqip in patients with central retinal vein occlusion and macular edema.Methods A total of 60 patients with central retinal vein occlusion and macular edema in the Department of Ophthalmology in Shanghai Pudong Hospital from January 2016 to December 2018 were selected and divided into two groups including laser-only group and laser combined with anti-VEGF drug treatment group(combined group),with 30 cases in each group.There were no other eye diseases such as glaucoma cataract in both groups,and there was no significant difference in fundus status.In the combined group,the intravitreal injection of compaqip was performed,and the non-perfusion area photocoagulation was performed 1 week later.The patients in the laser-only group were treated with photocoagulation in the non-perfusion area and the standard photocoagulation treatment in the macular areaseveral times.The changes of the best corrected visual acuity,fundus and OCT of the laser-only group and the combined group before and after treatment were observed.Results After treatment,the BCVA of both groups was higher than that before treatment and the CMT was lower than that before treatment.The difference was statistically significant(P<0.05).The combined group and the simple laser group showed that the combined group was better than the simple laser group,and the difference was statistically significant (P<0.05).Conclusion Laser treatment combined with anti-VEGF drugs of retinal vein occlusion combined with cystoid macular edema can effectively improve the retinal thickness of the macular area and best correct visual acuity,and restore visual function.