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雷珠单抗与阈下微脉冲激光治疗视网膜分支静脉阻塞继发黄斑水肿的比较。

Comparison of ranibizumab and subthreshold micropulse laser in treatment of macular edema secondary to branch retinal vein occlusion.

作者信息

Buyru Özkurt Yelda, Akkaya Sezen, Aksoy Sibel, Şimşek Mert Hakan

机构信息

1 Department of Ophthalmology, Fatih Sultan Mehmet Training and Research Hospital, Saglik Bilimleri University, İstanbul, Turkey.

2 Ophthalmology Clinic, Sultanbeyli Ersoy Hospital, İstanbul, Turkey.

出版信息

Eur J Ophthalmol. 2018 Nov;28(6):690-696. doi: 10.1177/1120672117750056. Epub 2018 Apr 26.

Abstract

PURPOSE

: To compare the effects of intravitreal ranibizumab injection and yellow (577 nm) subthreshold micropulse laser treatment in patients with macular edema following non-ischemic branch retinal vein occlusion.

METHODS

: The medical records of 51 patients who underwent intravitreal ranibizumab (0.5 mg) injection or subthreshold micropulse laser for the treatment of macular edema due to branch retinal vein occlusion were retrospectively reviewed. Subthreshold micropulse laser was administered with a 10% duty cycle, 100 μm spot diameter, 200 ms exposure time. The patients received an injection or laser treatment at baseline and were, then, retreated as needed and were followed for 12 months. The mean best corrected visual acuity changes over the follow-up and the decrease in the mean central macular thickness were evaluated.

RESULTS

: A total of 27 and 24 patients were assigned to intravitreal ranibizumab and subthreshold micropulse laser subgroups, respectively. The mean number of treatment was 3.81 of intravitreal ranibizumab group and 1.5 of subthreshold micropulse laser group (p < 0.05). The subgroups were similar with regard to the mean score of best corrected visual acuity at baseline, at 1, 6, and 12 months (p > 0.05). The decrease in the mean central macular thickness was significant in both intravitreal ranibizumab and subthreshold micropulse laser groups at 1, 6, and 12 months than that of values at baseline (p < 0.05). No new ocular or systemic adverse events were observed.

CONCLUSION

: Our study results showed that intravitreal ranibizumab or yellow subthreshold micropulse laser treatment for macular edema due to branch retinal vein occlusion was not found to be superior to each other for reducing macular thickness and increasing visual acuity for 1-year period. Based on these results, subthreshold micropulse laser may be a useful alternative approach in the treatment of macular edema secondary to branch retinal vein occlusion.

摘要

目的

比较玻璃体内注射雷珠单抗与黄色(577纳米)阈下微脉冲激光治疗非缺血性视网膜分支静脉阻塞所致黄斑水肿患者的效果。

方法

回顾性分析51例行玻璃体内注射雷珠单抗(0.5毫克)或阈下微脉冲激光治疗视网膜分支静脉阻塞所致黄斑水肿患者的病历。阈下微脉冲激光治疗的参数为占空比10%、光斑直径100微米、曝光时间200毫秒。患者在基线时接受一次注射或激光治疗,随后根据需要进行再次治疗,并随访12个月。评估随访期间最佳矫正视力的平均变化以及中心黄斑厚度的平均减少量。

结果

分别有27例和24例患者被分配到玻璃体内注射雷珠单抗组和阈下微脉冲激光组。玻璃体内注射雷珠单抗组的平均治疗次数为3.81次,阈下微脉冲激光组为1.5次(p<0.05)。两组在基线、1个月、6个月和12个月时的最佳矫正视力平均得分相似(p>0.05)。玻璃体内注射雷珠单抗组和阈下微脉冲激光组在1个月、6个月和12个月时的中心黄斑厚度平均减少量均显著大于基线值(p<0.05)。未观察到新的眼部或全身不良事件。

结论

我们的研究结果表明,在为期1年的时间里,玻璃体内注射雷珠单抗或黄色阈下微脉冲激光治疗视网膜分支静脉阻塞所致黄斑水肿在降低黄斑厚度和提高视力方面并无优劣之分。基于这些结果,阈下微脉冲激光可能是治疗视网膜分支静脉阻塞继发黄斑水肿的一种有用的替代方法。

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