摘要
目的评估玻璃体内注射抗血管内皮生长因子(VEGF)药物治疗息肉样脉络膜血管病变(PCV)的临床效果。方法回顾性队列研究。纳入洛阳市第一人民医院2020年10月至2021年11月PCV 84例(84眼),按治疗方法分为两组,每组42例(42眼)。观察组给予玻璃体内注射抗VEGF治疗,对照组口服复方血栓通胶囊联合卵磷脂络合碘胶囊治疗。比较两组治疗前后最佳矫正视力(BCVA,logMAR)、黄斑中心区厚度(CMT)、视野敏感度、对比敏感度、视物变形率(Amsler方格表)及OCT,评估两组不良反应发生率。结果治疗后两组BCVA较术前改善,CMT降低。且与对照组比较,观察组治疗后1、3、6个月BCVA均较高,CMT较薄(均P<0.05);治疗后6个月两组10°和30°视野敏感度均有所改善,观察组高于对照组(P<0.05);治疗后3个月观察组3 cpd、6 cpd、12 cpd、18 cpd对比敏感度水平均较高(均P<0.05);治疗后1、3个月,观察组视物变形率28.57%(12/42)、23.80%(10/42)均低于对照组50.00%(21/42)、45.23%(19/42)(均P<0.05);与对照组比较,治疗后观察组总黄斑体积(TMV)、视网膜色素上皮层脱离高度(PEDH)、视网膜色素上皮层脱离面积(PEDA)、视网膜色素上皮层脱离体积(PEDV)均较低(均P<0.05)。观察组和对照组不良反应发生率分别为16.66%(7/42)、14.28%(6/42),两组比较差异无统计学意义(P>0.05)。结论玻璃体内注射抗VEGF治疗PCV,有利于降低CMT,改善患者视力和视物变形率,同时能有效提高患者视野敏感度和对比敏感度,且不会增加不良反应发生率。
Objective To investigate the clinical efficacy of intravitreal injection of anti-vascular endothelial growth factor(VEGF)in the treatment for polypoidal choroidal vasculopathy(PCV).Methods This was a retrospective cohort study.A total of 84 eyes of 84 patients with PCV from Oct.2020 to Nov.2021 in the First People’s Hospital of Luoyang were divided into two groups based on treatment methods,with 42 eyes of 42 patients in each group.The observation group was treated with intravitreal injection of anti-VEGF,and the control group was treated with oral Xueshuantong capsule and lecithin complex iodine capsule.Best corrected visual acuity(BCVA,logMAR),central macular thickness(CMT),visual field sensitivity,contrast sensitivity,visual deformation rate(Amsler chart)and OCT before and after treatment were compared between the two groups,and the incidence of adverse reactions was evaluated.Results After treatment,BCVA increased and CMT decreased in both groups,and BCVA was higher and CMT was thinner in the observation group at 1,3 and 6 months after treatment compared with those in the control group(all P<0.05).At 6 months after treatment,the sensitivity of 10°and 30°field of view in both groups improved,with better results in the observation group(P<0.05).The contrast sensitivity of 3 cpd,6 cpd,12 cpd and 18 cpd were higher in the observation group at 3 months after treatment(all P<0.05).At 1 and 3 months after treatment,the visual deformation rates of the observation group were 28.57%(12/42)and 23.80%(10/42),which were lower than those of the control group[50.00%(21/42)and 45.23%(19/42)](all P<0.05).Compared with the control group,total macular volume(TMV),pigment epithelial detachment height(PEDH),pigment epithelial detachment area(PEDA)and pigment epithelial detachment volume(PEDV)in the observation group after treatment were lower(all P<0.05).The incidence of adverse reactions was 16.66%(7/42)in the observation group and 14.28%(6/42)in the control group,respectively,and there was no significant difference between the two groups(P>0.05).Conclusion Intravitreal injection of anti-VEGF in the treatment of PCV is beneficial to reduce the central thickness of macular retina,improve visual acuity and reduce visual object deformation rate of patients.It also effectively improves the sensitivity of visual field and contrast sensitivity of patients,and does not increase the incidence of adverse reactions.
作者
钱苗苗
王晓霞
范琼艳
Qian Miaomiao;Wang Xiaoxia;Fan Qiongyan(Department of Ophthalmology,Luoyang First People’s Hospital,Luoyang 471000,China)
出处
《中华眼外伤职业眼病杂志》
2023年第7期510-516,共7页
Chinese Journal of Ocular Trauma and Occupational Eye Disease
关键词
病变
血管
脉络膜
息肉样
注射
玻璃体内
因子
生长
内皮
血管
抗
Lesion,vascular,choroid,polypoid
Injection,intravitreal
Factors,growth,endothelium,blood vessels,anti
作者简介
通信作者:钱苗苗,Email:Dr.qianmiao@163.com,电话:0379-63990944。
