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玻璃体内注射雷珠单抗联合或不联合激光光凝与玻璃体内植入地塞米松联合或不联合激光光凝治疗视网膜分支静脉阻塞继发黄斑水肿的安全性和有效性比较

Comparison of the Safety and Efficacy of Intravitreal Ranibizumab with or without Laser Photocoagulation Versus Dexamethasone Intravitreal Implant with or without Laser Photocoagulation for Macular Edema Secondary to Branch Retinal Vein Occlusion.

作者信息

Kumar Prashant, Sharma Yog Raj, Chandra Parijat, Azad Rajvardhan, Meshram Girish Gulab

机构信息

Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.

Department of Pharmacology, Postgraduate Institute of Medical Education and Research and Dr. Ram Manohar Lohia Hospital, New Delhi, India.

出版信息

Folia Med (Plovdiv). 2019 Jun 1;61(2):240-248. doi: 10.2478/folmed-2018-0081.

Abstract

BACKGROUND

There is an ambiguity regarding the therapy of choice for patients with macular edema following branch retinal vein occlusion (BRVO).

AIM

The purpose of the study was to compare the efficacy and safety of ranibizumab (3 injections 0.5 mg) versus ranibizumab (1 injection 0.5 mg) with laser photocoagulation (LP) versus dexamethamethasone intravitreal (IVT) implant (0.7 mg) with or without LP in patients with macular edema following BRVO.

MATERIALS AND METHODS

60 eyes of 60 patients were divided into 4 groups. Group 1 received IVT ranibizumab (3 injections 0.5 mg), Group 2 received IVT ranibizumab (1 injection 0.5 mg) + LP, Group 3 received dexamethasone IVT implant (0.7 mg), and Group 4 received dexamethasone IVT implant (0.7 mg) + LP. The endpoints were the difference in mean changes in best corrected visual acuity (BCVA), central macular thickness (CMT), and inter-group differences in contrast sensitivity (CS), retinal sensitivity (RS), and intraocular pressure (IOP).

RESULTS

BCVA gains in Group 1 (18.00±8.51) patients were significantly (p < 0.05) higher than patients in Groups 2 (10.00±10.26), 3 (9.50±9.60), and 4 (10.50±10.97), after 6 months of therapy. No significant inter-group variation was found in the CMT, CS, and RS.

CONCLUSIONS

Ranibizumab (3 injections 0.5 mg) showed significantly higher BCVA gains at 6 months post-therapy. Improvements in the BCVA, CMT, CS, and RS were comparable initially in all the therapies.

摘要

背景

视网膜分支静脉阻塞(BRVO)后黄斑水肿患者的首选治疗方法存在争议。

目的

本研究的目的是比较雷珠单抗(3次注射,每次0.5毫克)与雷珠单抗(1次注射,0.5毫克)联合激光光凝(LP),以及地塞米松玻璃体内(IVT)植入物(0.7毫克)联合或不联合LP,用于治疗BRVO后黄斑水肿患者的疗效和安全性。

材料与方法

60例患者的60只眼被分为4组。第1组接受玻璃体内注射雷珠单抗(3次注射,每次0.5毫克),第2组接受玻璃体内注射雷珠单抗(1次注射,0.5毫克)+LP,第3组接受地塞米松玻璃体内植入物(0.7毫克),第4组接受地塞米松玻璃体内植入物(0.7毫克)+LP。观察指标为最佳矫正视力(BCVA)的平均变化差异、中心黄斑厚度(CMT),以及组间对比敏感度(CS)、视网膜敏感度(RS)和眼压(IOP)的差异。

结果

治疗6个月后,第1组(18.00±8.51)患者的BCVA提高幅度显著高于第2组(10.00±10.26)、第3组(9.50±9.60)和第4组(10.50±10.97)患者(p<0.05)。CMT、CS和RS在组间未发现显著差异。

结论

治疗6个月后雷珠单抗(3次注射,每次0.5毫克)的BCVA提高幅度显著更高。所有治疗方法在初始阶段对BCVA、CMT、CS和RS的改善效果相当。

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