摘要
目的:探讨玻璃体腔内注射雷珠单抗连续3针、单独1针治疗黄斑部脉络膜新生血管的临床疗效差异。方法:选取2017年1月1日—2019年1月1日于我院治疗的47眼黄斑部脉络膜新生血管患者进行回顾性分析,根据雷珠单抗玻璃体腔注射次数不同,将雷珠单抗连续治疗3针的23眼患者设为观察组,雷珠单抗治疗1针的24眼患者设为对照组,比较治疗前、治疗后1个月及3个月两组患者视力状况,黄斑区视网膜厚度变化,脉络膜新生血管突破视网膜色素上皮层的宽度、高度变化,以及脉络膜新生血管渗漏情况,并观察两组不良反应发生情况。结果:观察组治疗后1个月、3个月视力提高两行及以上眼数比例高于对照组,差异有统计学意义(P<0.05);观察组治疗后1个月、3个月黄斑区视网膜厚度显著低于对照组,差异有统计学意义(P<0.05);观察组治疗后1个月、3个月脉络膜新生血管突破视网膜色素上皮层的宽度、高度显著低于对照组,差异有统计学意义(P<0.05);对照组治疗后3个月脉络膜新生血管突破视网膜色素上皮层的高度高于本组治疗后1个月,差异有统计学意义(P<0.05);对照组治疗后1个月、3个月脉络膜新生血管停止渗漏眼数比例显著高于观察照,差异有统计学意义(P<0.05);治疗随访期间,两组患者均未发生眼部不良反应。结论:(1)玻璃体腔内注射雷珠单抗可有效治疗黄斑部脉络膜新生血管,且连续治疗3针疗效明显优于治疗1针,更利于患者视力的稳定;(2)脉络膜新生血管突破视网膜色素上皮层的高度对于评估病情进展较宽度更有意义;(3)视网膜色素上皮层或外界膜是否完整,对于评估脉络膜新生血管持续治疗和预后有重要意义。
Objective:To investigate the difference of clinical efficacy of three consecutive and one single injection of ranibizumab in the treatment of choroidal neovascularization in macular region.Methods:Selected January 1st 2017 to January 1st 2019 in our hospital treatment of 47 eyes macular choroid neovascularization patients,were retrospectively analyzed,according to the number of times of ranibizumab injection into the vitreous cavity,the 23 eyes treated with 3 consecutive doses of ranibizumab were set as the observation group,and the 24 eyes treated with 1 dose of ranibizumab were set as the control group.Compared before treatment,after treatment two groups of patients with visual acuity status,macular retinal thickness change,choroid neovascularization breakthrough width and height of the cortex on retinal pigment changes,and choroid leakage of new blood vessels,the occurrence of adverse reactions in the two groups was observed.Results:The visual acuity of the observation group increased by two or more eyes at 1 month and 3 months after treatment,which was higher than that of the control group,and the difference was statistically significant(P<0.05).The thickness of macular area retina in the observation group was significantly lower than that in the control group in 1 month and 3 months after treatment,and the difference was statistically significant(P<0.05).The width and height of choroidal neovascularization in the observation group were significantly lower than those in the control group in 1 month and 3 months after treatment(P<0.05).Control group after treatment for 3 month choroid neovascularization break through the height of the cortex on retinal pigment higher than that of group 1 month after treatment,the difference was statistically significant(P<0.05).In the control group,the proportion of eyes with choroidal neovascularization stopping leakage in 1 month and 3 months after treatment was significantly higher than that of observation group,and the difference was statistically significant(P<0.05).During the follow-up period,no ocular adverse reactions occurred in either group.Conclusion:(1)Vitreous injection of ranibizumab can effectively treat macular choroidal neovascularization,and the effect of continuous treatment with 3 doses is significantly better than that of 1 dose,which is more conducive to the stability of vision of patients.(2)The height at which choroidal neovascularization breaks through the retinal pigment epithelium is more significant for assessing the disease progression than the width.(3)Retinal pigment epithelium or outer limiting membrane integrity is of great significance for evaluating the continuous treatment and prognosis of choroidal neovascularization.
作者
张丹
王皎皎
ZHANG Dan;WANG Jiaojiao(Department of Ophthalmology,Armed police Chongqing Corps Hospital,Chongqing City 400061)
出处
《医学理论与实践》
2020年第18期2979-2982,2994,共5页
The Journal of Medical Theory and Practice
关键词
黄斑部脉络膜新生血管
血管内皮细胞生长因子
视网膜色素上皮层
外界膜
雷珠单抗
Choroidal neovascularization in macular area
Vascular endothelial growth factor
Retinal pigment epithelium
Outer limiting membrane
Ranibizumab
