红花黄色素注射液联合抗VEGF药物治疗非缺血性视网膜中央静脉阻塞

Safflor yellow injection combined with anti-vascular endothelial growth factor drugs in the treatment of non-ischemic central retinal vein occlusion

摘要:

目的：分析红花黄色素注射液联合抗血管内皮生长因子(VEGF)药物治疗非缺血性视网膜中央静脉阻塞(CRVO)的疗效和安全性。

方法：选取2017-04/2021-12于南昌大学附属眼科医院接受治疗的非缺血性CRVO合并黄斑水肿患者91例91眼，随机分为观察组(47例47眼，采用红花黄色素注射液联合玻璃体腔注射雷珠单抗治疗)和对照组(44例44眼，采用玻璃体腔注射雷珠单抗治疗)。随访11mo，观察两组患者最佳矫正视力(BCVA)和中心凹视网膜厚度(CRT)改善情况，并记录视网膜出血完全吸收、抗VEGF药物注射次数、缺血性CRVO发生情况及全身和眼部并发症发生情况。

结果：治疗后1、2、3、5、7、9、11mo，两组患者BCVA和CRT均较治疗前显著改善，且治疗后3、5、7、9、11mo，观察组患者BCVA和CRT均优于对照组(均P<0.05)。治疗后5、7、9、11mo时，观察组患者视网膜出血完全吸收率均高于对照组(P<0.05)。随访期间，观察组患者抗VEGF药物注射次数明显少于对照组(4.83±1.05次 vs 5.75±1.01次，P<0.05)，缺血性CRVO发生率明显低于对照组(21% vs 86%，P<0.05)，且两组患者均未出现与治疗相关的全身和眼部并发症。

结论：红花黄色素注射液联合抗VEGF药物是治疗非缺血性CRVO安全有效的方法，可显著改善视力，降低CRT，该治疗方案与抗VEGF药物单药治疗相比可增加视网膜出血完全吸收率、减少抗VEGF药物注射次数、减少缺血性CRVO发生率。

Abstract:

AIM: To analyze the efficacy and safety of safflor yellow injection combined with anti-vascular endothelial growth factor(VEGF)drug in the treatment of non-ischemic central retinal vein occlusion(CRVO).

METHODS: A total of 91 patients(91 eyes)with non-ischemic CRVO complicated with macular edema who were treated in the Affiliated Eye Hospital of Nanchang University from April 2017 to December 2021 were selected. They were randomly divided into observation group, with 47 cases(47 eyes)treated with safflor yellow injection combined with intravitreal injections of ranibizumab, and control group with 44 cases(44 eyes)who were treated with intravitreal injections of ranibizumab. Followed-up for 11mo, the best corrected visual acuity(BCVA)and macular central retinal thickness(CRT)of the two groups were observed and the cases of complete absorption of retinal hemorrhage, the times of anti-VEGF drug injections, the cases of ischemic CRVO, and the occurrence of systemic or ocular complications were recorded.

RESULTS: At 1, 2, 3, 5, 7, 9 and 11mo after treatment, the BCVA and CRT in both groups were significantly improved compared with those before treatment, and BCVA and CRT in the observation group were superior to the control group at 3, 5, 7, 9 and 11mo after treatment(all P<0.05). At 5, 7, 9 and 11mo after treatment, the complete absorption rate of retinal hemorrhage in the observation group was higher than that in the control group(P<0.05). During the follow-up period, the anti-VEGF drug injection in the observation group was significantly less than that in the control group(4.83±1.05 vs. 5.75±1.01, P<0.05), and the incidence of ischemic CRVO was significantly lower than that in the control group(21% vs. 86%, P<0.05), and there were no treatment-related systemic and ocular complications in both groups.

CONCLUSION: Safflor yellow injection combined with anti-VEGF drugs is a safe and effective method for the treatment of non-ischemic CRVO, which can significantly improve vision and reduce CRT. It can increase the complete absorption rate of retinal hemorrhage, reduce the times of anti-VEGF drug injections and the incidence of ischemic CRVO compared with monotherapy of anti-VEGF drug.