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玻璃体内注射曲安奈德与贝伐单抗治疗视网膜分支静脉阻塞继发黄斑水肿的比较

The comparison of intravitreal triamcinolone and bevacizumab in patients with macular edema secondary to branch retinal vein occlusion.

作者信息

Gokce Gokcen, Sobaci Gungor, Durukan Ali Hakan, Erdurman Fazil Cuneyt

机构信息

Department of Ophthalmology, Sarıkamis Military Hospital, Kars, Turkey.

Faculty of Medicine, Department of Ophthalmology, Gulhane Military Medical Academy, Ankara, Turkey.

出版信息

Clin Ophthalmol. 2014 Feb 7;8:355-62. doi: 10.2147/OPTH.S58468. eCollection 2014.

Abstract

PURPOSE

This study was conducted to compare the efficacy and safety of intravitreal triamcinolone acetonide (IVTA) and intravitreal bevacizumab (IVB) in the treatment of macular edema related to branch retinal vein occlusion (BRVO), using the new optical coherence tomography parameters.

MATERIAL AND METHODS

The medical records of 62 patients (IVTA n=26; IVB n=36) with macular edema secondary to BRVO and at least 12 months follow-up between 2007 and 2011 were evaluated by within-group and inter-group comparisons.

RESULTS

Both groups were similar in terms of demographic characteristics (P>0.05). Best corrected visual acuity (BCVA) improvement and central subfoveal thickness (CST) reduction were significantly higher in the IVTA group at only the third month (P<0.05). In nonischemic BRVO, while BCVA improvement was significantly higher in the IVTA group at the third and sixth months (P<0.05), no significant difference was found in CST reduction at all visits (P>0.05). In ischemic BRVO, no significant difference was found in BCVA improvement at all visits, but CST reduction was significantly higher in the IVTA group at the first and third months. Logarithmic optical coherence tomography change (LogOCTc) and relative change in retinal thickness (RCRT) showed the same levels of significance in the comparisons. Relative change in retinal thickening (RCRTing) was more valuable compared to the other parameters in the subgroup analyses.

CONCLUSION

There was no difference between groups at the 12th month. IVTA was more efficient than IVB in regard to BCVA improvement in nonischemic BRVO in the early follow-up. IVTA made significant retinal thinning compared to IVB in ischemic BRVO in the early period. RCRTing and LogOCTc are important parameters used to monitor the response to treatment in BRVO. Because of the similar levels of significance, RCRT and LogOCTc can be used interchangeably.

摘要

目的

本研究旨在使用新的光学相干断层扫描参数,比较玻璃体内注射曲安奈德(IVTA)和玻璃体内注射贝伐单抗(IVB)治疗视网膜分支静脉阻塞(BRVO)相关黄斑水肿的疗效和安全性。

材料与方法

对2007年至2011年间62例继发于BRVO的黄斑水肿患者(IVTA组26例;IVB组36例)的病历进行评估,通过组内和组间比较。

结果

两组在人口统计学特征方面相似(P>0.05)。仅在第三个月时,IVTA组的最佳矫正视力(BCVA)改善和中心凹下厚度(CST)降低显著更高(P<0.05)。在非缺血性BRVO中,虽然IVTA组在第三个月和第六个月时BCVA改善显著更高(P<0.05),但在所有随访中CST降低无显著差异(P>0.05)。在缺血性BRVO中,所有随访中BCVA改善无显著差异,但IVTA组在第一个月和第三个月时CST降低显著更高。对数光学相干断层扫描变化(LogOCTc)和视网膜厚度相对变化(RCRT)在比较中显示出相同的显著性水平。在亚组分析中,视网膜增厚相对变化(RCRTing)比其他参数更有价值。

结论

在第12个月时两组无差异。在早期随访中,IVTA在非缺血性BRVO的BCVA改善方面比IVB更有效。在缺血性BRVO的早期,与IVB相比,IVTA使视网膜显著变薄。RCRTing和LogOCTc是用于监测BRVO治疗反应的重要参数。由于显著性水平相似,RCRT和LogOCTc可互换使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb6e/3923617/77becc735130/opth-8-355Fig1.jpg

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