玻璃体内注射康柏西普联合周边视网膜选择性光凝治疗视网膜静脉阻塞继发黄斑水肿的疗效及安全性

目的　观察玻璃体内注射康柏西普联合周边视网膜选择性光凝治疗视网膜静脉阻塞继发黄斑水肿的疗效及安全性。方法　选择２０１４年３月至２０１５年３月于我院眼科就诊的视网膜静脉阻塞继发黄斑水肿患者２６例２６眼，予以玻璃体内注射康柏西０．５ｍｇ。１周后，根据ＦＦＡ结果，对于周边视网膜存在无灌注区的患者，联合周边视网膜选择性光凝；分别于术后１个月、２个月、３个月进行复查，若黄斑水肿无明显减轻或复发［黄斑中心凹视网膜厚度（ｃｅｎｔｒａｌｍａｃｕｌａｒｔｈｉｃｋｎｅｓｓ，ＣＭＴ）＞２２５μｍ或ＣＭＴ增厚＞１００μｍ］，行重复注射；对比分析患眼治疗前后最佳矫正视力（ｂｅｓｔ-ｃｏｒｒｅｃｔｅｄｖｉｓｕａｌａｃｕｉｔｙ，ＢＣＶＡ）、ＣＭＴ的变化并观察有无眼部或全身并发症。结果　治疗前患眼ＢＣＶＡ为０．０９±０．０５，治疗后１周、１个月、２个月、３个月时ＢＣＶＡ分别为０．１６±０．０６、０．２５±０．０７、０．２１±０．０７、０．２０±０．０８，各时间点与治疗前相比，差异均有统计学意义（ｔ１周＝９．３９２，ｔ１个月＝１４．４４０，ｔ２个月＝９．２９５，ｔ３个月＝６．７０９，均为Ｐ＜０．０５）；治疗前患眼ＣＭＴ为（６０８．５０±１１９．４５）μｍ，治疗后１周、１个月、２个月、３个月ＣＭＴ分别为（３６４．３５±８４．３３）μｍ、（２７９．１２±７９．７３）μｍ、（３０８．００±７７．９０）μｍ、（３２６．７７±９１．７８）μｍ。复查各时间点与术前相比，差异均有统计学意义（ｔ１周＝１１．１２４，ｔ１个月＝１４．６６７，ｔ２个月＝１４．１７６，ｔ３个月＝１３．４３４，均为Ｐ＜０．０５）；随访期间，２６眼均未发生与药物、玻璃体内注射相关的局部及全身的严重不良反应。结论　玻璃体内注射康柏西普联合周边视网膜选择性光凝治疗视网膜静脉阻塞继发黄斑水肿具有较好的疗效及安全性，可以减轻黄斑水肿，提高患者的视力。

Intravitreal injection of conbercept combined with selective peripheral retinal photocoagulation for macular edema secondary to retinal vein occlusion

Objective To observe the clinical effects and safety of intravitreal injection of conbercept combined with selective peripheral retinal photocoagulation for macular edema secondary to retinal vein occlusion ( RVO-ME) . Methods Twenty-six patients (26 eyes) with RVO-ME from March 2014 to March 2015 in our hospital were retrospectively analyzed. All patients received intravitreal injection of 0. 5 mg conbercept at frrst visit. One week later , according to the FFA ’ s results , patients with non-perfusion area in peripheral retina received selective laser photocoagulation. The best-corrected visual acuity ( BCVA) . central macular thickness ( CMT) were observed before and I month ,2 months .3 months after treatment. Then , the changes in pre-treatment and posttreatment were compared , and the related complications were recorded. Results BCVA before treatment and I week, I month.2 months. 3 months after treatment were 0. 09 + 0. 05 .0. 16 + 0. 06 .0. 25 + 0. 07 , 0. 21 + 0. 07 .0. 20 + 0. 08 , respectively, the posttreatment were higher than pre-treatment ( t, week = 9. 392 , t, morm = 14. 440 , t2 morm s = 9. 295 , t3 mo iths = 6. 709 , all P < 0. 05 ) . The central macular thickness before treatment and I week. I month.2 months, 3 months after treatment were ( 608. 50 + 119. 45 ) ym, ( 364. 35 + 84. 33 ) pm, ( 279. 12 + 79. 73 ) ym , ( 308. 00 +77. 90 ) pm, ( 326. 77 +91. 78 ) ym , respectively , the post-treatment were lower than pre-treatment( t, week = 9. 392 , t, month = 14. 440 , tz months = 9. 295 , t3 morm s = 6. 709 . all P < 0. 05 ) . After treatment , no serious complication was seen. Conclusion The efficacy and safety of intravitreal conbercept combined with selective peripheral retinal photocoagulation for macular edema secondary to retinal vein occlusion are assured.can reduce the macular edema and improve the visual acuity.