玻璃体腔内注射伐单抗(bevacizumab)联合眼底激光治疗视网膜分支静脉阻塞继发黄斑水肿的疗效研究.pdf

玻璃体腔内注射贝伐单抗（Bevacizumab）联合眼底激光治疗视 网膜分支静脉阻塞继发黄斑水肿的疗效研究 摘 要 目的对玻璃体腔内注射贝伐单抗（Bevacizumab）联合眼底激光治疗视网膜分支静脉阻 塞（BRVO）继发黄斑水肿的进行临床疗效观察。 方法 临床病例回顾。对象为我院门诊诊断为BRVO 继发黄斑水肿患者 12 例 12 眼；所有 患者至少进行一次玻璃体腔内注射 Bevacizumab 1.25mg，同时联合眼底激光进行治疗。 对所有患者均行视力、裂隙灯、眼底检查，相干光断层扫描（OCT）, 定期行眼底荧光造 影(FFA)，微视野(MP-1)检查。随访时间为 12 个月，观察其视功能回复水平及网膜水肿 消退情况。 结果 12 例患者平均接受玻璃体腔内注射 3.08±1.08 次, 随访末，12 例患者视力改善 11 例(91.67％)，视力不变1 例(8.3％)；OCT 检查 12 例患者平均黄斑区厚度术(CFT)术 前为 533.25±109.26um，术后 1 月下降为 365.42±120.95 μm，术后3 月为 283.00± 128.25 μm, 术后6 月为230.00±57.37 μm 术后12月为219.56±56.58 μm,差异具有统计学 意义(P 0.05)。但2 例（16.67％）患者OCT 显示黄斑区仍有少量积液存在。治疗及随 访过程中未见明显不良反应发生。 结论 对 BRVO 阻塞继发黄斑水肿患者进行玻璃体腔内注射Bevacizumab，可保存或改善 矫正视力、有效减轻黄斑水肿程度，但须重复治疗。黄斑区渗漏是引起黄斑水肿复发的 主要原因，联合眼底激光可减少黄斑水肿复发的频率，有较好的临床应用价值。 关键词 视网膜分支静脉阻塞, 黄斑水肿, 抗VEGF, 激光 Intravitreal Bevacizumab (Avastin) Combined with Laser Photocoagulation for Treatment of Macular Edema Secondary to Branch Retinal Vein Occlusion Abstract Objective To observe the efficacy of intravitreal bevacizumab (Avastin) combined with Agron laser for treatment of macular edema secondary to retinal vein occlusion (BRVO). Methods Retrospective review of 12 eyes of 12 patients who underwent BRVO were treated with at least one intravitreal injection (1.25mg ) of Bevacizumab combined with laser photocoagulation. Best corrected visual acuity (BCVA), fundus photography, optical coherence tomography （OCT ）, fluorescein angiography (FFA) and microperimetry (MP-1) were committed. Patients were followed for 12 months. Results There were 12 consecutive patients who received intravitreal bevacizumab injections of a mean number of retreatments was 3.08±1.08. Eleven (91.67%) of the 12 eyes showed improved BCVA and one (8.3％) maintained after 12-month follow-up. The mean CFT decreased from 533.25±10