玻璃体腔内注射TA与雷珠单抗治疗CRVO继发黄斑水肿的对照研究

目的：比较曲安奈德(TA)与雷珠单抗(ranibizumab)治疗视网膜中央静脉阻塞(central retinal vein occlusion，CRVO)继发黄斑水肿的的临床疗效及安全性。

方法：回顾性分析继发黄斑水肿的CRVO患者40例40眼。其中20例20眼接受玻璃体腔注射TA(1mg，0.1mL)治疗，其余20例20眼接受玻璃体腔注射雷珠单抗(0.5mg，0.05mL)治疗。观察两组治疗前及治疗后1，2wk； 1，2，3，6mo患者最佳矫正视力、黄斑中心凹厚度(CMT)及眼压的改变。

结果：TA组及雷珠单抗组于玻璃体腔注药1，2wk； 1，2，3，6mo后最佳矫正视力较治疗前明显提高(P<0.05)； 但两组之间无明显差异(P>0.05)。两组于玻璃体注药后1，2wk； 1，2，3，6mo，CMT较治疗前有明显降低(P<0.05)，但两组之间无明显差异(P>0.05)。TA组玻璃体腔注药后2wk及4wk眼压较治疗前明显升高(P<0.05)。雷珠单抗组玻璃体腔注药后各时间点眼压均无明显升高(P>0.05)。注药后第1，2wk； 2，3，6mo，TA组眼压改变与雷珠单抗组无明显差异(P>0.05)，注药后1mo，TA组眼压改变要明显高于雷珠单抗组(P<0.05)。

结论：玻璃体腔内注射雷珠单抗是目前CRVO继发黄斑水肿的有效而且安全的治疗手段。与TA相比其在提高最佳矫正视力及降低CMT的同时几乎不会发生眼部及全身并发症。

Comparison between intravitreal Ranibizumab and Tramicinolone acetonide for macular edema secondary to central retinal vein occlusion

AIM:To compare the efficacy and safety of intravitreal ranibizumab to those of triamcinolone acetonide(TA)injection for the treatment of macular edema secondary to central retinal vein occlusion(CRVO).

METHODS:This retrospective study included 40 eyes of 40 patients with macular edema associated with CRVO. Twenty patients 20 eyes were treated with intravitreal injection of triamcinolone acetonide(1mg, 0.1mL), the other 20 patients 20 eyes accepted intravitreal ranibizumab(0.5mg, 0.05mL). The change of best corrected visual acuity(BCVA), central macular thickness(CMT), and intraocular pressure(IOP)before treatment and at 1, 2wk, 1, 2,3,6mo post-injection in the two groups were observed.

RESULTS:BCVA was improved at 1, 2wk, 1, 2,3,6mo post-injection in the TA group(P<0.05)and ranibizumab group(P<0.05). No significant difference was found between the two groups(P>0.05). CMT decreased significantly within each group(P<0.05), and no significant difference between groups was found(P>0.05). In the TA group, the IOP was significantly higher at 2wk and 4wk than before treatment(P<0.05). In the ranibizumab group, no elevated IOP was observed at 1, 2wk, 1, 2,3,6mo(P>0.05). However, the IOP at 1mo was significantly higher in the TA group than that in the ranibizumb group(P<0.05).

CONCLUSION:Intravitreal ranibizumab is an effective and safe treatment method for macular edema secondary to CRVO. It can effectively improve BCVA and reduce CMT without ocular and systemic complications compared with intravitreal TA.