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目的评价康柏西普治疗视网膜中央静脉阻塞(CRVO)的疗效与安全性研究。方法临床病例治疗前后对照研究。对2016年1月—2017年6月就诊于该院眼科已确诊为视网膜中央静脉阻塞,全身一般情况尚可,无严重心脑血管等全身疾病和局部手术禁忌证的86例(86眼)患者纳入研究。对患眼均给予玻璃体腔注射康柏西普,必要时给予重复注射。观察术前和术后1周、1个月、2个月、3个月时患者的最佳矫正视力(best corrected visual acuity,BCVA)、光学相干断层(OCT)扫描测定黄斑中心凹区视网膜厚度(central macular thickness,CMT)、荧光素血管造影(fundus fluorescein angiography,FFA)及患者药物相关的眼部并发症及全身不良反应等情况。结果在86眼中视力提高者83眼,占96.5%。视力稳定者3眼,占3.5%。治疗后1周、1个月、2个月、3个月时分别为0.92±0.22、0.88±0.24、0.70±0.29、0.49±0.27,与治疗前相比差异均具有统计学意义。治疗前CMT为(528.23±138.23)μm,治疗后1周,1个月、2个月、3个月后CMT分别为(373.47±117.44)μm、(303.26±104.73)μm、(277.27±101.98)μm、(206.73±87.20)μm,与治疗前相比差异均具有统计学意义。对所有患者随访3个月后,行FFA检查,黄斑区渗漏完全消失81例(94.2%),黄斑区有渗漏现象但明显减轻5例(5.8%)。尚未发现与药物相关的眼部继发症及全身不良反应。结论玻璃体腔注射康柏西普能在短期内治疗CRVO是安全有效的,可以有效的改善黄斑水肿,提高患者视力,改善生活质量。
Objective To evaluate the efficacy and safety of concomitant treatment of central retinal vein occlusion (CRVO). Methods Control study of clinical cases before and after treatment. From January 2016 to June 2017, 86 patients (86 eyes) with ophthalmologic diagnosis of central retinal vein occlusion, general general condition, and no systemic diseases such as cardiovascular and cerebrovascular diseases and contraindications of local surgery were admitted to this hospital. Included in the study. The eyes were given intravitreal injection of concomitant, if necessary, given repeated injections. The best corrected visual acuity (BCVA) and optical coherence tomography (OCT) scans were performed before and 1 week, 1 month, 2 months and 3 months after operation to measure the retinal thickness including central macular thickness (CMT), fundus fluorescein angiography (FFA) and patient’s drug-related ocular complications and systemic adverse reactions. Results In 86 eyes 83 eyes improved, accounting for 96.5%. 3 eyes were stable, accounting for 3.5%. One week, one month, two months and three months after treatment were 0.92 ± 0.22, 0.88 ± 0.24, 0.70 ± 0.29 and 0.49 ± 0.27, respectively, which were all significantly different from those before treatment. The CMT before treatment was (528.23 ± 138.23) μm, and the CMT was (373.47 ± 117.44) μm, (303.26 ± 104.73) μm and (277.27 ± 101.98) μmolup, 1 month, 1 month, 2 months and 3 months after treatment respectively μm, (206.73 ± 87.20) μm respectively, which were significantly different from those before treatment. All the patients were followed up for 3 months. FFA was performed in 81 patients (94.2%) with complete disappearance of macular leakage and 5 cases (5.8%) with obvious leakage in macular area. No drug-related ocular complications and systemic adverse effects have been found. Conclusion Intravitreal injection of compstatin can be effective in short-term treatment of CRVO, which can effectively improve macular edema, improve visual acuity and improve quality of life.