玻璃体腔注射雷珠单抗联合地塞米松玻璃体内植入剂治疗视网膜静脉阻塞合并黄斑水肿的疗效观察

Observation of the Therapeutic Efficacy of Intravitreal Injections of Ranibizumab Combined with Dexamethasone for the Treatment of Retinal Vein Occlusion Accompanied by Macular Edema

摘要: 目的：评估玻璃体腔内注射地塞米松玻璃体内植入剂联合雷珠单抗注射液与单独使用雷珠单抗注射液在治疗视网膜静脉阻塞引起的黄斑水肿方面的疗效差异。方法：回顾性病例对照研究，本研究收集自2023年1月~2023年9月就诊于金川集团职工医院眼科的静脉阻塞合并黄斑水肿(retinavein occlusion, RVO-ME)的患者114例(114只眼)的临床资料，根据治疗方式分为2组：每组各57例(57只眼)，其中单药治疗组采用单独的玻璃体腔注射雷珠单抗进行治疗，联合治疗组采用雷珠单抗联合地塞米松玻璃体内植入剂进行玻璃体腔注射治疗。对比分析两组患者在治疗前及治疗后1、2、3和6个月的眼压、最佳矫正视力(Best corrected visual acuity, BCVA)以及黄斑中心凹视网膜厚度(central Retinal thickness, CRT)的变化情况。以期更全面地评估两种治疗方案的疗效和安全性。结果：组内比较：两组患者平均眼压、BCVA、CRT在术后不同时间点差异均有统计学意义(P < 0.05)，两组患者在平均BCVA在术后不同组别之间差异均有统计学意义(P < 0.05)，两组患者在BCVA、CRT不同时间与组别之间有交互作用(P < 0.05)；分组治疗后1月、2月、3月、6月，两组患者BCVA及CRT的改善程度较治疗前有所好转(P < 0.05)。结论：玻璃体腔注射雷珠单抗联合地塞米松治疗RVO-ME与单独使用雷珠单抗相比较，能一定程度上改善患者的视力，使疗效维持时间更持久。

Abstract: Objective: Further elucidating the comparative therapeutic effectiveness of intravitreal injection of a dexamethasone intravitreal implant in conjunction with ranibizumab injection, against the administration of ranibizumab alone, in addressing macular edema stemming from retinal vein occlusion. Method: Retrospective case control study This study collects clinical data of 114 patients with venous occlusion combined with macular edema (RVO-ME) who are admitted to the Ophthalmology Department of Jinchuan Group Staff Hospital from January 2023 to September 2023. They are divided into 2 groups according to treatment mode: There were 57 patients in each group (57 eyes), in which the monotherapy group was treated with single intravitreal injection of leizumab, and the combined treatment group was treated with intravitreal injection of leizumab combined with dexamethasone intravitreal implant. The changes of IOP, best corrected visual acuity (BCVA) and central Retinal thickness (CRT) in macular fovea were compared between the two groups before treatment and 1, 2, 3 and 6 months after treatment. In order to comprehensively evaluate the efficacy and safety of both treatment options. Results: There was no statistically significant difference in preoperative baseline data between the two groups of patients (P > 0.05); The results of repeated measures analysis of variance showed that there were statistically significant differences in mean intraocular pressure, BCVA, and CRT between the two groups of patients at different time points after surgery (P < 0.05). There were also statistically significant differences in mean BCVA between different groups of patients after surgery (P < 0.05), and there was an interaction between the two groups of patients at different time points and groups of BCVA and CRT (P < 0.05); At 1, 2, 3, and 6 months after grouping treatment, the improvement of BCVA and CRT in both groups of patients significantly improved compared to before treatment (P < 0.05); Conclusions: Intravitreal injection of ranibizumab combined with dexamethasone in the treatment of RVO-ME can effectively improve the visual acuity of patients compared to the use of ranibizumab alone, with a longer duration of efficacy maintenance.