| 王硕,刘畅,贾雯,等.雷珠单抗治疗视网膜分支静脉阻塞继发黄斑水肿过程中玻璃体的状态变化及其对疗效影响[J].安徽医药,2023,27(7):1466-1471. |
| 雷珠单抗治疗视网膜分支静脉阻塞继发黄斑水肿过程中玻璃体的状态变化及其对疗效影响 |
| Changes in the state of vitreous body during the treatment of BRVO-ME with ranibizumab and its effect on the efficacy |
| |
| DOI：10.3969/j.issn.1009-6469.2023.07.042 |
| 中文关键词: 视网膜静脉闭塞 黄斑水肿 玻璃体后脱离 雷珠单抗 |
| 英文关键词: Retinal vein occlusion Macular edema Posterior vitreous detachment Ranibizumab |
| 基金项目:安徽省自然科学基金项目( 1908085MH254) |
|
| 摘要点击次数: 2319 |
| 全文下载次数: 1035 |
| 中文摘要: |
| 目的探讨雷珠单抗治疗视网膜分支静脉阻塞继发黄斑水肿(branch retinal vein occlusion-macular edema，BRVO-ME)过程中玻璃体状态的动态变化及其对疗效的影响。方法回顾性分析 2021年 2—6月在中国科学技术大学附属第一医院眼科接受玻璃体腔注射雷珠单抗治疗的初诊 BRVO-ME病人 35例 35眼，根据间接眼底镜， B超及光学相干断层扫描( optical coherence tomography，OCT)结果对玻璃体状态进行评估，分为无 PVD组 17例，局限 VMA组 5例，广泛 VMA组 7例，完全 PVD组 6例。各组病人连续 3月每月注射雷珠单抗 1次，随访 4个月以上，在每次注射 1月后观察病人的玻璃体状态、黄斑厚度(central macular thickness，CMT)和最佳矫正视力( best corrected visual acuity，BCVA)。结果 35眼在治疗后 BCVA和 CMT均显著好转。各组病人在注药 1次， 2次， 3次后的 BCVA均差异无统计学意义。在第 1次注药后，局限 VMA组的 CMT［452.00(433.50，591.50)μm］与无 PVD［336.00(311.00，361.00)μm，P=0.016］、广泛 VMA组［335.00(251.00，357.00)μm，P=0.028］相比较差异明显。第 2次注药后，限组VMA组的 CMT［358.00(330.50，504.00)μm］与无 PVD组［ 259.00(235.00，291.00)μm，P=0.021］、广泛 VMA组［ 237.00(233.00，局278.00)μm，P=0.036］相比较仍然差异较大。第 3次注药后，各组间 CMT差异无统计学意义。与未治疗时相比，第 1次治疗( P=0.086)及第 2次治疗后( P=0.057)，各组病人的玻璃体状态差异无统计学意义。第 3次治疗后，无 PVD6眼，局限 VMA5眼，广泛 VMA9眼，完全 PVD15眼，与未治疗时相比，无 PVD组改变 11眼，局限 VMA组改变 4眼，广泛 VMA组改变 7眼，完全 PVD改变 0眼，病人玻璃体状态较未治疗时差异有统计学意义(P=0.001)。结论不同基线玻璃体状态的 BRVO-ME病人，在经过 3次玻璃体腔雷珠单抗注射治疗之后均能获得明显的视力获益和水肿消退。基线玻璃状态对病人视力无明显影响，局限 VMA可能在治疗初期影响水肿消退，但在经过 3次注射后即无明显差异。经过 3次注射治疗后，病人玻璃体状态整体向后脱离方向发展。 |
| 英文摘要: |
| Objective To investigate the dynamic changes of vitreous state in the treatment of macular edema secondary to branchretinal vein occlusion with Ranibizumab and its influence on the curative effect.Methods A retrospective study on thirty-five eyes of 35 newly diagnosed BRVO-ME patients who received intravitreal injection of ranibizumab in the Department of Ophthalmology, theFirst Affiliated Hospital of University of Science and Technology of China from February 2021 to June 2021 was conducted. The patients were divided into no PVD group (n = 17), limited VMA group (n = 5), extensive VMA group (n = 7), and complete PVD group(n = 6). Patients in each group were injected once a month within 3 months and followed up for more than 4 months. Vitreous status,macular thickness and best corrected visual acuity of patients were observed 1 month after each injection.Results BCVA and CMT were significantly improved in 35 eyes after treatment. There was no significant difference in BCVA in each group after injection 1, 2and 3times. After the first injection, the CMT of the VMA focal group [452.00 (433.50, 591.50) μm] was significantly higher than that ofthe no PVD group [336.00 (311.00, 361.00) μm, P=0.016], the VMA broad group [335.00 (251.00, 357.00) μm, P=0.028]. After thesecond injection, the CMT of the VMA focal group [358.00 (330.50, 504.00) μm] was still significantly higher than that of the no PVDgroup [259.00 (235.00, 291.00) μm,P=0.021], the VMA broad group [237.00 (233.00, 278.00) μm, P=0.036]. After the third injection,there was no significant difference in CMT among all groups. There was no significant difference in the vitreous status between the firsttreatment (P=0.086) and the second treatment (P=0.057). After the third treatment, no PVD was observed in 6 eyes, the VMA focalgroup in 5 eyes, the VMA broad group in 9 eyes, and complete PVD in 15 eyes. Compared with those before treatment, there were 11eyes with changes in the non-PVD group, 4 eyes with changes in the VMA focal group, 7 eyes with changes in the VMA broad group, andno eyes with changes in the complete PVD. There was a significant difference in the vitreous status between the patients without treatment and those without treatment (P=0.001).Conclusions Patients with BRVO-ME in different vitreous states achieve significant visual acuity benefit and edema resolution after 3 rounds of intravitreal Ranibizumab injection. Different glass states has no significant effecton patients′ visual acuity. VMA focal may affect edema resolution at the initial stage of treatment, but there is no significant difference after 3 injections. The vitreous state of the patient tends to develop into detachment after 3 times vitreous injection of Ranibizumab. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
