视网膜分支静脉阻塞相关黄斑水肿不同治疗方案疗效评价

目的 比较单纯玻璃体内注射抗血管内皮生长因子(VEGF)药物和联合应用地塞米松玻璃体内植入剂治疗视网膜分支静脉阻塞(BRVO)相关黄斑水肿(ME)的效果。方法 回顾性分析BRVO相关ME的102例(102眼)患者的临床资料，分为两组，A组为单纯玻璃体内注射抗VEGF药物组(治疗期间接受任何一种抗VEGF药物),B组为玻璃体内注射抗VEGF药物和地塞米松玻璃体内植入剂组(不分先后顺序，治疗期间使用两种药物)。每月随访，共随访6个月及以上，末次注射后，连续3次随访均无视网膜下液，黄斑中心区厚度(CMT)变化≤50μm,且CMT≤250μm为观察终点。比较两组患者玻璃体内注药次数、治疗前及治疗后最佳矫正视力(BCVA)、眼压、CMT。结果 两组患者经治疗后均能有效改善BCVA及降低CMT,A组患者玻璃体内注药次数为(4.59±2.83)次，B组患者玻璃体内注药次数为(3.02±1.62)次，两组比较差异有统计学意义(P=0.00)。治疗前后，A组患者BCVA(logMAR)从0.77±0.47提高到0.48±0.44(P=0.00),B组患者BCVA从0.73±0.45提高到0.42±0.3...

Evaluation on the efficacy of different treatment options for macular edema in patients with branch retinal vein occlusion

Objective　To compare the efficacy of intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) drugs alone and its combination with dexamethasone intravitreal implant in the treatment of macular edema (ME) of patients with branch retinal vein occlusion (BRVO). Methods　The clinical data of 102 BRVO patients (102 eyes) with ME were retrospectively analyzed. The patients were divided into two groups: the patients in Group A were treated with intravitreal injection of anti-VEGF drugs (any anti-VEGF drug was administered); the patients in Group B were treated with intravitreal injection of anti-VEGF drugs and dexamethasone intravitreal implant (two kinds of drugs were administered during treatment, regardless of order). Follow up monthly for at least 6 months. There was no subretinal fluid and the change of central macular thickness (CMT) was ≤ 50 μm, with CMT ≤ 250 μm as the end point in all three consecutive follow-ups after the last injection. The times of intravitreal injections, best corrected visual acuity (BCVA), intraocular pressure (IOP) and CMT before and after treatment in the two groups were compared. Results　The BCVA and CMT in both groups improved significantly after the treatment. The number of intravitreal injections in group A was 4.59±2.83, and that of group B was 3.02±1.62, showing a significant difference (P=0.00). Before and after the treatment, the BCVA (logMAR) of group A increased from 0.77±0.47 to 0.48±0.44 (P=0.00), and that of group B increased from 0.73±0.45 to 0.42±0.35 (P=0.00). The CMT in group A decreased from (403.02±147.70) μm to (230.17±21.82) μm (P=0.00), and that in group B decreased from (393.96±94.61) μm to (236.87±22.98) μm (P=0.00). However, there were no significant differences in BCVA and CMT between the two groups in the observation end point (P>0.05). In group B, the IOP of 14.6% of patients treated with dexamethasone intravitreal implant increased to ≥25 mmHg (1 kPa=7.5 mmHg) within one month after the therapy and could be controlled by topical application of anti-glaucoma drugs. Conclusion　Intravitreal injection of anti-VEGF drugs alone and combination with dexamethasone intravitreal implants are both effective in the treatment of ME related to BRVO, and combination with dexamethasone intravitreal implantation can reduce the number of intravitreal injections during the observation period.