【摘要】 目的:探讨玻璃体腔内注射雷珠单抗(IVR)联合577 nm阈值下微脉冲激光(STML)治疗病理性近视继发脉络膜新生血管(PM-CNV)的临床疗效。方法:选取2021年12月至2023年12月于包头市眼科医院就诊的PM-CNV患者52例52眼作为研究对象。采用数字抽签方式将患者按1:1随机分为两组:对照组(26眼)仅接受IVR治疗;试验组(26眼)接受IVR-STML联合治疗。对比两组治疗前及治疗后3、6、9、12 mo最佳矫正视力(BCVA)、中心凹黄斑厚度(CMT)值和脉络膜新生血管(CNV)面积及IVR总次数的差异。结果:两组患者治疗前一般资料具有可比性。与治疗前相比,治疗后3、6、9、12 mo,两组患者视力均改善,CMT均降低、CNV面积均减小(均P<0.05);试验组治疗3、6 mo CMT及治疗6、9、12 mo CNV面积明显低于对照组(均P<0.05)。治疗12 mo内,试验组平均IVR总次数明显低于对照组(P<0.05)。结论:IVR单药治疗与IVR-STML联合治疗PM-CNV均能改善患者BCVA,且两组视力改善效果相当。IVRSTML联合治疗能更持久稳定地维持黄斑区解剖结构,有效抑制CNV病灶进展,并显著减少抗VEGF药物注射次数。该方案有助于减轻治疗负担、改善远期预后,具有显著临床优势。更多还原

【Abstract】 AIM:To investigate the clinical efficacy of intravitreal ranibizumab injection(IVR) combined with 577 nm subthreshold micropulse laser(STML) in the treatment of pathological myopic choroidal neovascularization(PM-CNV).METHODS:Totally 52 patients(52 eyes) who were diagnosed with PM-CNV at Baotou Eye Hospital from December 2021 to December 2023 were selected in the study.Patients were randomly assigned in a 1:1 ratio using digital randomization to two groups:control group(26 eyes) treated with IVR monotherapy,and experimental group(26 eyes) was treated with IVR-STML combined therapy.The best corrected visual acuity(BCVA),central macular thickness(CMT),CNV area,and total number of IVR were compared before treatment and at 3,6,9,and 12 mo after treatment.RESULTS:The general data of the two groups before treatment were comparable.The BCVA was improved,CMT was decreased,and CNV area was reduced at 3,6,9,and 12 mo after the initial treatment(all P<0.05).The experimental group exhibited significantly lower CMT at3 and 6 mo,and reduced CNV area at 6,9,and 12 mo compared to the control group(all P<0.05).The average times of IVR in the experimental group was significantly less than that of the control group(P<0.05).CONCLUSION:Both IVR monotherapy and IVR-STML combined therapy for PM-CNV can improve BCVA with comparable improvement.IVR-STML therapy offers durable macular stabilization,effectively controls CNV progression,and reduces anti-VEGF injections.It lowers treatment burden and improves long-term outcomes and is recommended as a preferred treatment strategy.更多还原