抗VEGF药物联合PRP治疗新生血管性青光眼的效果

目的：探究抗血管内皮生长因子(vascular endothelial growth factor，VEGF)联合视网膜激光光凝(PRP)治疗新生血管性青光眼(neovascular glaucoma，NVG)的效果，以及对房水中VEGF、血小板源性生长因子-C(platelet derived growth factor-C，PDGF-C)的影响。

方法：选择2016-11/2017-11在我院接受检查和治疗的NVG患者90例93眼，随机分为对照组和观察组。对照组使用PRP治疗，观察组使用PRP联合玻璃体注射雷珠单抗治疗。比较两组患者治疗后1mo的临床疗效、虹膜新生血管和视力恢复情况。并分析治疗前和治疗后1mo视网膜静脉循环时间、眼压、视网膜神经纤维层(retinal nerve fiber layer，RNFL)厚度、视野缺损值、房水中VEGF和PDGF-C水平以及不良反应。

结果：治疗后1mo观察组的临床疗效、虹膜新生血管消失情况和视力恢复情况优于对照组，差异有统计学意义(P<0.05)。治疗后1mo观察组的视网膜静脉循环时间、眼压、视野缺损值、房水VEGF和PDGF-C水平均显著低于对照组，RNFL厚度显著高于对照组，差异有统计学意义(P<0.05)。两组患者不良反应发生情况比较，差异无统计学意义(P>0.05)。

结论：对NVG患者使用视网膜激光光凝联合抗VEGF药物治疗可更有效抑制血管生成，恢复视网膜功能，具有更好的疗效，这可能与联合治疗具有更佳的下调VEGF与PDGF-C的作用有关。

Anti-VEGF medicine with PRP for neovascular glaucoma

AIM:To investigate the effect of anti-vascular endothelial growth factor(VEGF)combined with pan retinal photocoagulation(PRP)on neovascular glaucoma(NVG)and its effect on VEGF and platelet-derived growth factor-C(PDGF-C)in aqueous humor.

METHODS: A total of 90 patients with NVG(93 eyes)who underwent examination and treatment in our hospital from November 2016 to November 2017 were randomly divided into control group and observation group. The control group was treated with PRP, and the observation group was treated with laser photocoagulation combined with vitreous injection of ranibizumab. The clinical efficacy, iris neovascularization and visual recovery were compared between the two groups after treatment. And we compared the retinal vein circulation time, intraocular pressure, retinal nerve fiber layer thickness, visual field defect value, VEGF and PDGF-C levels in aqueous humor and adverse reactions before and after treatment.

RESULTS: At 1mo after treatment, the clinical efficacy, iris neovascularization and visual recovery were better than the control group(P<0.05). After treatment, the retinal vein circulation time, intraocular pressure, visual field defect, aqueous humor VEGF and PDGF-C levels were significantly lower in the observation group than in the control group, and RNFL was significantly higher than the control group(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).

CONCLUSION: The use of PRP combined with anti-VRGF drugs for NVG can inhibit angiogenesis and restore retinal function more effectively, which may be better because the combination therapy has better down-regulation of VEGF and PDGF-C.