目的:观察不同剂量、不同次数玻璃体腔注射avastin(beyacizumab)治疗视网膜中央静脉阻塞(central retinal veinocclusion,CRVO)伴黄斑水肿(macularedema,ME)的临床效果。方法:回顾分析2007-4/2009-10我院就诊,经眼底检查、荧光眼底血管造影(FFA)、光学相干断层扫捕(OCT)检查确诊的CRVO伴ME患者72例75眼,A组38例39眼,其中A1组20例21眼玻璃体腔内注射avastin 1.25mg(0.05mL);A2组18例18眼玻璃体腔内注射avastin1.25mg后间隔4wk再次重复治疗。B组34例36眼,其中B1组16例16眼玻璃体腔内注射avastin 2.0mg(0.08mL);B2组18例20眼玻璃体腔内注射avastin2.0mg后间隔4wk再次重复治疗。对比每次治疗前、及治疗后1,2,4wk的视力、眼压、眼底,治疗前和治疗后4wk的FFA表现和OCT测量黄斑中心视网膜厚度。结果:72例75眼中有58例61眼视力和黄斑水肿改善,A2组与A1组、B2组与B1组比较差异有统计学意义(P<0.01),A1组与B1组、A2组与B2组比较差异没有统计学意义。结论:玻璃体腔内注射avastin可改善视网膜中央静脉阻塞继发黄斑水肿患者的视力和黄斑水肿高度,重复治疗效果更明显,但增加剂量并不会明显改善黄斑水肿高度。

AIM:To observe clinical effects of intravitreous injection of avastin(bevacizumab) in central retinal vein occlusion (CRVO) with macular edema(ME). METHODS:Indirect ophthalmoscopy,optical coherence tomography(OCT) and fundus fluorescein angiography (FFA) confirmed that 72 patients 75 eyes had CRVO with ME in our hospital from April 2007 to October 2009.Group A had 38 patients 39 eyes,group A1 of 20 patients 21 eyes received intravitreal injection of 1.25mg(0.05mL) avastin, group A2 of 18 patients with 18 eyes received intravitreal injection of 1.25mg(0.05mL) avastin and the treatment was repeated after 4 weeks.Group B had 34 patients 36 eyes,group B1 of 16 patients 16 eyes received intravitreal injection of 2.0mg(0.08mL) avastin,group B2 of 18 patients 20 eyes received intravitreal injection of 2.0mg (0.08mL) avastin and the treatment was repeated after 4 weeks.Visual acuity,intraocular pressure and fundus were compared before each treatment,1 week,2,4 weeks after treatment.The performance of FFA and OCT macular retinal thickness measurement were compared before treatment and 4 weeks after treatment. RESULTS:Out of 72 patients 75 eyes,visual acuity of 58 patients 61 eyes was improved and macular edema reduced.The difference between group A1 and group A2,group B1 and group B2 was significant(P<0.01). There was no statistically significant difference between group A1 and group B1,group A2 and group B2. CONCLUSION:Intravitreal injection of avastin can improve the CRVO in patients with ME secondary to a high degree of visual acuity and ME,repeated treatment effect is more obvious.But the increase intravitreal injection of avastin did not significantly reduce the high degree of ME.

R774.1

中国陕西省西安市科技局基金资助项目(No.YF07143)~~