雷珠单抗治疗视网膜静脉阻塞合并黄斑水肿的疗效及影响视力恢复的因素分析
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Effect of intravitreal injection of Ranibizumab on macular edema in retinal vein occlusion and the analysis of visual acuity recovery
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    摘要:

    目的:观察玻璃体腔注射雷珠单抗治疗视网膜静脉阻塞合并黄斑水肿(RVO-ME)的效果,分析影响患者视力恢复的因素。

    方法:回顾性研究。选取2018-01/2019-06在我院眼科门诊接受治疗的RVO-ME患者106例106眼进行研究。所有患者均给予0.05mL雷珠单抗玻璃体腔注射患眼治疗,观察治疗效果。根据治疗3mo后患者的视力恢复程度将其分为良好组和不良组,应用二分类Logistic回归分析筛选影响患者视力恢复的因素。

    结果:治疗后1d,1wk,1、3mo时的患眼BCVA(LogMAR)较治疗前均明显改善,黄斑中心凹视网膜厚度(CRT)较治疗前均明显减小(均P<0.05),治疗前后患眼平均眼压比较无差异(P>0.05)。所有患者均未发生眼内炎、眼压升高、晶状体混浊、视网膜脱落等并发症。Logisitic回归分析显示,治疗前黄斑中心凹区毛细血管无灌注、黄斑中心凹区外界膜不完整、内丛状层结构不完整是影响视力恢复的因素。

    结论:玻璃体腔注射雷珠单抗治疗RVO-ME能有效减轻患眼ME,改善视力,治疗后眼压正常,而且具有操作方便、可重复进行、对组织损伤小、无明显不良反应。治疗前黄斑中心凹区毛细血管无灌注、黄斑中心凹区外界膜不完整、内丛状层结构不完整是影响视力恢复的因素。

    Abstract:

    AIM: To observe the effect of intravitreal injection of ranibizumab in the treatment of retinal vein occlusion macular edema(RVO-ME), and to apply Logistic regression analysis to screen the factors that affect the vision recovery of patients.

    METHODS: A total of 106 patients(106 eyes)with retinal vein occlusion and macular edema who were treated in the ophthalmology clinic of our hospital from January 2018 to June 2019 were selected for the study. The clinical data of the patients were retrospectively analyzed and all were given 0.05mL ranibizumab. The monoclonal antibody was injected into the vitreous cavity of the affected eye, and the patients were followed up to observe the treatment effect. The patients were divided into good group and poor group according to the degree of vision recovery after 3mo of treatment, and the two-class Logistic regression analysis was used to screen the factors that affect the vision recovery of patients.

    RESULTS: The Logarithm of the minimum angle of resolution(LogMAR)of the affected eye at 1d, 1wk, 1, and 3mo after treatment was significantly lower than before treatment, and the macular foveal retinal thickness(CRT)was significantly lower than before treatment. The difference was statistically significant(all P<0.05), and there was no significant difference in the average intraocular pressure of the affected eye before and after treatment(P>0.05). During and after the treatment, the patient did not develop complications such as endophthalmitis, increased intraocular pressure, lens opacity, and retinal detachment. Logistic regression analysis showed that there was no capillary perfusion in the foveal area of the macula and the center of the macula before treatment. Incomplete outer membrane and incomplete inner plexiform layer structure in the concave area are risk factors that affect the efficacy of ranibizumab injection.

    CONCLUSION: Intravitreal injection of ranibizumab in the treatment of retinal vein occlusion combined with macular edema is effective and safe in the short term. It can effectively reduce macular edema of the affected eye, improve vision, and normal intraocular pressure after treatment, and it is easy to operate and effective. It has the advantages of repeating, little damage to tissues, no obvious adverse reactions, less pain for patients, economical and practical. In addition, the lack of capillary perfusion in the foveal area of the macula before treatment, the incomplete outer membrane of the foveal area, and the incomplete structure of the inner plexiform layer are risk factors that affect the efficacy of ranibizumab in the treatment of retinal vein occlusion and macular edema.

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宋华,李景波.雷珠单抗治疗视网膜静脉阻塞合并黄斑水肿的疗效及影响视力恢复的因素分析.国际眼科杂志, 2022,22(3):509-512.

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  • 收稿日期:2021-07-31
  • 最后修改日期:2022-01-28
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  • 在线发布日期: 2022-02-24
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