玻璃體腔注射康柏西普治療視網膜靜脈阻塞并黃斑水腫

陸慧琴，武炳慧，吳惠琴

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·臨床研究·

玻璃體腔注射康柏西普治療視網膜靜脈阻塞并黃斑水腫

陸慧琴，武炳慧，吳惠琴

?METHODS:Twenty-seven eyes of 27 patients with RVO received initially intravitreous injection of Conbercept combined with selective peripheral retinal or panrentinal photocoagulation. Best-corrected visual acuity (BCVA, logMAR vision) and central retina thickness (CRT) were performed before and after the injection. These indicators before treatment, after 12wk treatment of 8 patients (8 eyes) of central retinal vein occlusion (CRVO) who received no less than three times intravitreous injection treatments were analyzed. And also analyze these indicators of before treatment, after 4wk treatment of 19 patients (19 eyes) of branch retinal vein occlusion (BRVO) who received at less singal intravitreous injection treatment.

?RESULTS:The mean BCVA and CRT of 27 patients were 0.8822±0.5601, (713.8±224.8)μm and 0.5963±0.4481, (376.7±185.5)μm before treatment and at the last follow-up visit, respectively. The mean injection time was 4.75 and the mean following month was 13 of 8 patients of CRVO. Before treatment, the mean BCVA of these 8 patients (8 eyes) was 0.9802±0.6663, after received three times intravitreous injection treatment was 0.7082±0.4629 and 0.8517±0.5895 at the final follow-up. The improvement was no significant difference (P>0.05). The mean CRT at 3mo and the last follow-up were respectively (306.8±117.7)μm and (487.5±201.6)μm, which significantly (P<0.05) improved from (835.1±289.3)μm before treatment. The mean injection time of 19 patients of BRVO was 2.2 and the mean following month was 9. The mean BCVA was 0.8124±0.4529 before treatment，after received the first time intravitreous injection treatment and at the final follow-up were 0.4789±0.2792 and 0.4888±0.3163, respectively. The improvement was significantly (P<0.05). The mean CRT at 1mo and the last follow-up were (283.8±129.3) and (330.6±161.4)μm, which also significantly (P<0.05) improved from (662.7±176.6)μm before treatment. No serious complications were observed.

?CONCLUSION:Intravitreous injection with Conbercept is effective in macular edema of RVO, reducing CRT and enhancing the visual acuity. And the duration of efficacy is longer of BRVO than CRVO, single injection can maintain around about 1y.

目的：觀察玻璃體腔注射康柏西普治療視網膜靜脈阻塞(RVO)并黃斑水腫患者的臨床療效。

方法：視網膜靜脈阻塞并黃斑水腫患者27例27眼，其中中央靜脈阻塞(CRVO)8例8眼，分支靜脈阻塞(BRVO)19例19眼接受玻璃體腔注射康柏西普聯合適時眼底激光光凝治療，觀察患眼治療前、后最佳矯正視力(BCVA)和黃斑中心視網膜厚度(CRT)的轉歸情況。

結果：患者27例27眼治療前平均BCVA(最小分辨角對數視力LogMAR)和CRT為0.8822±0.5601和713.8±224.8μm，末次隨訪時分別為0.5963±0.4481和376.7±185.5μm。其中8例CRVO患者平均注射次數為4.75次，平均隨訪時間為13mo，治療前平均LogMAR視力為0.9802±0.6663，接受3次注藥治療后和末次隨訪時分別為0.7082±0.4629和0.8517±0.5895，治療后視力有所提高，但差異無統計學意義(P>0.05)；平均CRT治療前為835.1±289.3μm，3次治療后和末次隨訪時分別為306.8±117.7、487.5±201.6μm，差異有統計學意義(P<0.05)。19例BRVO患者平均注射次數為2.2，隨訪時間為9mo，治療前平均LogMAR視力為0.8124±0.4529，在接受1次注藥治療后及末次隨訪時分別為0.4789±0.2792、0.4888±0.3163，治療后視力明顯提高，差異有統計學意義(P<0.05)；平均CRT治療前為662.7±176.6μm，1次注藥治療后及末次隨訪時分別為283.8±129.3、330.6±161.4μm，差異有統計學意義(P<0.05)。所有患者隨訪期間均未見明顯嚴重并發癥發生。

結論：玻璃體腔注射康柏西普能夠減輕RVO并黃斑水腫患者視網膜水腫程度，提高患眼視力，對BRVO并黃斑水腫的患者療效持續時間相對較長，單次注射療效最長可維持1a。

視網膜靜脈阻塞；玻璃體腔注射；康柏西普

引用：陸慧琴，武炳慧，吳惠琴.玻璃體腔注射康柏西普治療視網膜靜脈阻塞并黃斑水腫.國際眼科雜志2016;16(12):2264-2267

0引言

視網膜靜脈阻塞(retinal vein occlusion，RVO)合并黃斑水腫(macular edema，ME)是導致RVO患者視力下降的首要原因，常導致視力不可逆性的損害。目前，治療RVO的基礎是嚴格控制血壓等全身狀況，主要治療方法包括視網膜激光光凝、玻璃體腔注射曲安奈德以及抗血管內皮生長因子(vascular endothelial growth factor，VEGF)藥物、玻璃體切除手術等。同糖……