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[摘要]
目的:探讨康柏西普联合全视网膜激光光凝治疗缺血型视网膜中央静脉阻塞的临床疗效。
方法:选取2017-01/2019-01在我院诊治的缺血型视网膜中央静脉阻塞患者80例80眼进行回顾性研究。根据治疗方式分为两组,A组40例40眼采用玻璃体腔注射康柏西普3+PRN治疗联合全视网膜激光光凝治疗; B组40例40眼采用玻璃体腔注射康柏西普3+PRN治疗。分别记录治疗前及治疗后3、6、12mo患者的最佳矫正视力(BCVA)和黄斑中心凹视网膜厚度(CMT),观察药物注射次数及不良反应。
结果:治疗后12mo与治疗前比较,A组BCVA由1.05±0.58改善至0.41±0.37(P<0.01),B组由0.98±0.51改善至0.63±0.53(P<0.01),两组间比较无差异(P>0.05); A组CMT由592.30±79.75μm下降至260.08±86.23μm(P<0.01),B组CMT由604.98±81.73μm下降至406.83±162.97μm(P<0.01),且两组间比较有差异(P<0.01)。A组康柏西普注射3.15±0.43次,B组3.83±1.06次,两组间比较有差异(P<0.01)。随访期间,A组患者均未出现不良反应,B组继发新生血管性青光眼2例2眼。
结论:康柏西普治疗缺血型视网膜中央静脉阻塞安全有效,联合全视网膜激光光凝可以显著改善视力,黄斑水肿消退效果更佳更稳定,降低复发率,减少并发症。
[Key word]
[Abstract]
AIM: To investigate the clinical effectiveness of conbercept intravitreal injection combined with panretinal photocoagulation for ischemic central retinal vein occlusion.
METHODS: A retrospective study has been conducted on 80 patients(80 eyes)of ischemic central retinal vein occlusion diagnosed and treated at Dalian No.3 People's Hospital from January 2017 to January 2019. These 80 patients have been divided into two groups based on treatment methods. In Group A, 40 patients(40 eyes)were given 3+PRN intravitreal injection of conbercept combined with panretinal photocoagulation. In Group B, 40 patients(40 eyes)accepted the treatment of 3+PRN intravitreal injection with conbercept. The best corrected visual acuity(BCVA)and central macular thickness(CMT)before and after treatment were recorded respectively at 3mo, 6mo and 12mo, and the clinical effectiveness and adverse reactions were observed and documented.
RESULTS: After 12mo: In group A, BCVA improved from 1.05±0.58 to 0.41±0.37(P<0.01).In group B, BCVA improved from 0.98±0.51 to 0.63±0.53(P<0.01). There was no significant difference between the two groups(P>0.05). In group A, CMT changed from 592.30±79.75μm to 260.08±86.23μm(P<0.01). In group B, CMT changed from 604.98±81.73μm to 406.83±162.97μm(P<0.01).CMT was better in Group A than Group B(P<0.01). The mean number of injections in group A(3.15±0.43 times)and group B(3.83±1.06 times)was statistically significant(P<0.01). During follow-up, no adverse events happened in Group A. Two patients were neovascular glaucoma after central retinal vein occlusion in Group B.
CONCLUSION:It is safe and effective to use intravitreal injection of conbercept to treat central retinal vein occlusion. Combining intravitreal injection of conbercept with panretinal photocoagulation can significantly improve BCVA, lead to further regression of macular edema and a more stabilized positive effect. It proves to reduce recurrence rate of the central retinal vein occlusion and decrease the chances of any complications.
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