微脉冲激光联合雷珠单抗玻璃体腔内注射治疗非缺血型BRVO继发黄斑水肿

Micropulse laser combined with intravitreal injection of Ranibizumab in the treatment of macular edema secondary to non-ischemic branch retinal vein occlusion

摘要:

目的：探讨微脉冲激光联合雷珠单抗玻璃体腔内注射治疗非缺血型视网膜分支静脉阻塞(BRVO)继发黄斑水肿(ME)的疗效。

方法：选取2020-01/2022-03在我院接受治疗的非缺血型BRVO继发ME患者200例200眼作为本次研究对象，按照随机数字表法分为对照组(100例100眼)和观察组(100例100眼)。其中对照组给予雷珠单抗玻璃体腔内注射治疗，观察组给予微脉冲激光联合雷珠单抗玻璃体腔内注射治疗。比较两组最佳矫正视力(BCVA)、黄斑中心凹视网膜厚度(CMT)、黄斑中心凹下脉络膜厚度(SFCT)、总注药次数、黄斑区渗漏以及并发症发生情况。

结果：治疗后两组患者的BCVA均改善，且观察组治疗后1、3、6、12mo的BCVA优于对照组(均P<0.05)。治疗后两组患者的CMT、SFCT均降低，且观察组治疗后1、3、6、12mo的CMT、SFCT低于对照组(均P<0.05)。观察组治疗期间总注药次数明显少于对照组(4.06±1.12次 vs 5.32±1.15次，t=5.852，P<0.001)。对照组和观察组治疗后12mo的渗漏率分别为69.0%、27.0%，两组比较有差异(χ²=35.337，P<0.001)。对照组和观察组患者的并发症发生率分别为11.0%、5.0%，两组比较无差异(χ²=2.446，P=0.118)。

结论：微脉冲激光联合雷珠单抗玻璃体腔内注射治疗非缺血型BRVO继发ME的临床效果显著，能够提高患者的视力，改善ME，减少雷珠单抗总用药次数，且不会增加并发症发生率，安全系数高。

Abstract:

AIM: To investigate the efficacy of micropulse laser combined with intravitreal injection of ranibizumab in the treatment of macular edema(ME)secondary to non-ischemic branch retinal vein occlusion(BRVO).

METHODS: A total of 200 cases(200 eyes)of non-ischemic BRVO secondary to ME who were treated in our hospital from January 2020 to March 2022 were selected and divided into the control group(100 cases, 100 eyes)and the observation group(100 cases, 100 eyes)by random number table. The control group was given intravitreal injection of ranibizumab, and the observation group was given micropulse laser combined with intravitreal injection of ranibizumab. The best corrected visual acuity(BCVA), central macular thickness(CMT), subfoveal choroidal thickness(SFCT), total number of injections, macular leakage and complications were compared between two groups.

RESULTS: After treatment, the BCVA of the two groups were improved, and the BCVA of the observation group was better than those in the control group at 1, 3, 6 and 12mo after treatment(all P<0.05). After treatment, the CMT and SFCT of the two groups decreased, and the CMT and SFCT of the observation group was lower than those in the control group at 1, 3, 6 and 12mo after treatment(all P<0.05). The total number of injections in the observation group during the treatment period was less than that in the control group \〖(4.06±1.12)times vs.(5.32±1.15)times\〗(t=5.852, P<0.001). The leakage rates of the control group and the observation group after 12mo of treatment were 69.0% and 27.0% respectively, with statistical significance between the two groups(χ²=35.337, P<0.001). The incidence of complications in the control group and observation group were 11.0% and 5.0% respectively, with no statistical significance between the two groups(χ²=2.446, P=0.118).

CONCLUSION: Micropulse laser combined with intravitreal injection of ranibizumab has a significant clinical efficacy in the treatment of ME secondary to non-ischemic BRVO, which is safe and can improve patients' vision and ME, reduce the total doses of ranibizumab without increasing the incidence of complications.