玻璃体腔注射雷珠单抗联合物理治疗和手术治疗Coats病的效果

目的:探讨玻璃体注射雷珠单抗联合物理治疗和手术治疗Coats病的效果.方法:选取2013-05/2016-05在我院治疗的Coats病患者13例13眼,所有患眼给予玻璃体腔注射雷珠单抗治疗,同时联合巩膜外放液、激光光凝等治疗,观察患眼视力及视网膜复位情况.结果:选取的13眼中,玻璃体腔注射雷珠单抗联合巩膜外放液治疗4眼,联合激光光凝治疗3眼,联合玻璃体切除、剥膜、冷冻、硅油填充等治疗6眼,眼球保留率100%;患者治疗后6mo视力明显较治疗前改善,差异有统计学意义(P<0.05),视力比较:0.05~0.1、0.01~<0.05、指数、光感和手动眼数比例术前为0、0、38%、38%和23%,术后6mo为23%、23%、38%、15%和0;视网膜完全复位5眼(38%);基本复位3眼(23%);未复位5眼(38%).结论:玻璃体腔注射雷珠单抗联合物理治疗和手术治疗Coats病有一定效果,能提高或保持患者有限的视功能,避免因病变进展摘除眼球.

Efficacy of intravitreal injection of anti-VEGF drugs combination with other methods for Coats disease

AIM:To investigate the effect of intravitreal injection of anti-vascular endothelial growth factor (VEGF) drugs combined with other methods in the treatment of Coats disease.METHODS:Selected 13 patients 13 eyes with Coats disease in our hospital from May 2013 to May 2016.All eyes were treated with intravitreal injection of ranibizumab and combined with scleral drainage, laser photocoagulation and so on.We observed visual acuity and retinal reattachment.RESULTS:In 13 eyes, the treatment of 4 eyes with intravitreal injection of ranibizumab and combined with scleral drainage, 3 eyes combined laser photocoagulation, 6 eyes combined vitrectomy, membrane peeling, freezing, silicone oil filling or other treatments.Eyeball retention rate was 100%.Visual acuity at 6mo after treatment significantly improved compared with before treatment (P<0.05).The visual acuity was ≥0.05-0.1, 0.01-<0.05, counting finger, light perception and hand moving before treatment in 0, 0, 38%, 38% and 23%, after treatment were 23%, 23%, 38%, 15% and 0.Complete retinal reattachment was achieved in 5 eyes, accounting for 38%;basic reset in 3 eyes, accounting for 23%;5 eyes were not reset, accounting for 38%.CONCLUSION:Intravitreal injection of anti-VEGF drugs combined with other methods for the treatment of Coats disease have a certain effect, can improve or maintain the limited visual function, avoid enucleation of eyeball due to disease progression.