目的:评价贝伐单抗(Bevacizumab)联合格栅样光凝治疗视网膜中央静脉阻塞(central retinal vein occlusion,CRVO)黄斑水肿的临床疗效。方法:经纳入标准筛选后荧光素眼底血管造影(FFA)确诊CRVO引起黄斑水肿32例32眼。随机分为A和B两组,A组:玻璃体腔注射Bevacizumab(IVB)+格栅样光凝,B组:格栅样光凝。比较两组治疗后4,12,24wk最佳矫正视力、黄斑中心视网膜厚度(CMT)值、眼压,以及有无并发症发生情况。结果:A组疗效明显,视力提高快,视网膜厚度降低明显,在4,12,24wk观测黄斑区视网膜厚度分别为:351.81±57.68,320.44±58.94,296.50±52.15μm。视力及黄斑区厚度均与治疗前有显著性差异(P<0.05)。B组视力略有改善,但与治疗前无显著性差异(P>0.05),视网膜厚度降低,在4,12,24wk观测黄斑区视网膜厚度分别为:526.56±88.92,441.06±94.06,374.31±106.07μm。两组眼内压在治疗前后均无显著性差异(P>0.05)。A组应用激光的能量及点数均少于B组,减少治疗次数。结论:采用联合治疗方法能有效减轻黄斑水肿,提高视力,疗效持久。

AIM:To evaluate the efficacy of intravitreaI Becacizumab (IVB)combined with grid photocoagulation for the treatment of cystoid macular edema(CME)associated with central retinaI vein occlusion(CRVO).METHODS:Tirty-two cases(32 eyes)of CME associated with CRVO made a definite diagnosis by FFA were divided into two groups randomly.IVB combined with grid photocoagulation group(A group):16 eyes.Grid photocoagulation group(B group):16 eyes.Best corrected visual acuity(BCVA),central macular thickness(CMT),intraocular pressure(IOP) and complications at 4 weeks,12 weeks,24 weeks after treatment in these eyes were examined and compared between the two groups.RESULTS:BCVA of A group had improved and CMT were 351.81±57.68μm,320.44±58.94μm,296.50±52.15μm respectively at 4,12,24 weeks after treatment.Both of them had statistical significant difference before and after treatment.CMT of B group were 526.56±88.92μm,441.06±94.06μm,374.31±106.07μm respectively at 4,12,24 weeks after treatment.There was statistical significant difference before and after treatment.IOP of the two groups had no statistical significant difference before and after treatment.The energy and laser spots of B group were much more than those of A group.CONCLUSION:IVB combined with grid photocoagulation for the treatment of CME associated with CRVO has better efficacy than grid photocoagulation alone.

R774.5

中国陕西省科技攻关基金资助项目(No.2008K01-40)~~