Department of Ophthalmology, The Changsha Fourth Hospital (Affiliated Hospital of Medical College of Hunan Normal University), Changsha, 410006 Hunan, China.
Comput Math Methods Med. 2022 May 2;2022:2933663. doi: 10.1155/2022/2933663. eCollection 2022.
This study aimed at investigating the clinical effect of ranibizumab combined with panretinal photocoagulation in the treatment of macular edema in diabetic retinopathy (DR) patients. A parametric deformation model was constructed, and based on this, it was evaluated using optical coherence tomography (OCT) combined with fluorescein fundus angiography (FFA). 56 DR patients (80 eyes) who needed surgery were selected for OCT and FFA scanning, and 0.5 mg ranibizumab was administered intravitreal injection before surgery. It should observe the OCT and FFA image characteristics of patients. In addition, the vision correction status before the surgery, 1 month, 3 months, and 6 months after the surgery, the thickness of the macular retina, operation time, the number of intraoperative electrocoagulation, and complications of patients were recorded. It was found that 82.85% of patients had improved visual acuity after surgery. Compared with preoperative, the average logarithm of the minimum angle of resolution (logMAR) of patients at 6 months after surgery increased significantly ( < 0.01). With the increase of the grade of fibrosis and the grade of hemorrhage, the logMAR visual acuity recovery at 6 months after the surgery became worse; the macular retinal thickness at 6 months after the surgery decreased significantly ( < 0.01). With the increase of the grade of fibrous proliferation and the grade of bleeding, the operation time, the number of electrocoagulation, and the possibility of iatrogenic holes of patient would increase. It can be known that ranibizumab combined with panretinal photocoagulation surgery could not only reduce the macular edema but also effectively reduce the intraoperative bleeding, simplify the removal of proliferative membranes, decrease the number of electrocoagulation, and shorten the operation time, enhancing the visual function of patients.
本研究旨在探讨雷珠单抗联合全视网膜光凝治疗糖尿病视网膜病变（DR）患者黄斑水肿的临床效果。构建参数变形模型，在此基础上结合光学相干断层扫描（OCT）和荧光素眼底血管造影（FFA）进行评估。选择需要手术的 56 例 DR 患者（80 只眼）进行 OCT 和 FFA 扫描，手术前给予 0.5mg 雷珠单抗玻璃体腔注射。观察患者 OCT 和 FFA 图像特征。此外，记录患者术前、术后 1 个月、3 个月和 6 个月的视力矫正情况、黄斑视网膜厚度、手术时间、术中电凝次数及患者并发症发生情况。结果显示，术后 82.85%的患者视力得到改善。与术前相比，术后 6 个月患者平均最小分辨角对数（logMAR）显著提高（<0.01）。随着纤维化程度和出血程度的增加，术后 6 个月 logMAR 视力恢复情况变差；术后 6 个月黄斑视网膜厚度明显降低（<0.01）。随着纤维增殖程度和出血程度的增加，手术时间、电凝次数和医源性裂孔的发生可能性增加。可知，雷珠单抗联合全视网膜光凝术不仅能减轻黄斑水肿，还能有效减少术中出血，简化增殖膜的清除，减少电凝次数，缩短手术时间，提高患者的视觉功能。
