【作者】 张正；

【导师】 隋桂琴；

【作者基本信息】 吉林大学 ， 眼科学（专业学位）， 2015， 硕士

【摘要】 目的：研究玻璃体腔注射Lucentis治疗视网膜静脉阻塞继发黄斑水肿的疗效。方法：研究对象为2012年10月至2014年12月在我院治疗的视网膜静脉阻塞伴黄斑水肿的患者56例56眼的临床资料，全部患者分为2组，A组37眼给予Lucentis0.5mg玻璃体腔注射，根据病情进行重复注射；B组19眼给予球后注射曲安奈德20mg，根据病情进行重复注射；随访6个月，观察并记录治疗前及治疗后1周、1个月、3个月、6个月的光学相干断层成像（optical coherencetomography，OCT）测量的黄斑中心厚度（central macularthickness,CMT）、最佳矫正视力(Best Corrected Visual Acuity,BCVA)及眼压（intraocular pressure,IOP）。结果：CMT：A组治疗后1周、1个月、3个月、6个月CMT分别下降到346.4615±94.6032μm、319.8462±142.5879μm、300.2308±114.4852μm及280.1538±48.0136μm。B组治疗后1周、1个月、3个月、6个月CMT分别下降到466.0909±131.1613μm、487.8182±109.5014μm、419.0000±88.0682μm及374.1818±82.4364μm。BCVA：A组治疗后1周、1个月、3个月、6个月BCVA分别提高到0.3208±0.1352、0.3708±0.2088、0.4038±0.2321及0.3908±0.2084；B组治疗后1周、1个月、3个月、6个月BCVA分别提高到0.1645±0.1210、0.2109±0.1618、0.1945±0.1317及0.2527±0.1374。两组患者治疗后各个时期与其治疗前相比CMT降低程度均具有统计学意义（P<0.05），A组治疗各个时期与治疗前比较BCVA提高程度均具有统计学意义（P<0.05），但B组治疗各个时期与治疗前相比BCVA提高程度无统计学意义（P>0.05），A组治疗整个过程眼压均无眼压升高情况，B组患者治疗过程中有1例（5.26%）高于21mmHg，两组均未发现其他并发症。结论：1、Lucentis玻璃体腔注射对于治疗RVO致ME具有显著疗效，能显著消退黄斑水肿及提高患者视力；2、Lucentis玻璃体腔注射治疗RVO致ME可根据眼底情况决定是否重复注射；更多还原

【Abstract】 Objective: To study the curative effect of treating secondary macularoedema of retinal vein occlusion with lucentis intravitreal injection.Methods:The study objectives are56eyes’ clinical data of56casesof patients with retinal vein occlusion and macular edema, who came toour hospital for treatment during the period from October2012toDecember2014. All patients are divided into two groups. Among which37eyes in group A were treated with intravitreal injection ofLucentis0.5mg and repeatedly injections were used based on thepatient’s specific condition. While19eyes in group B were treated withretrobulbar injection of triamcinolone acetonide20mg and repeatedlyinjections were used based on the patient’s specific condition. Sincepatients were released from the hospital, they are required to take regularvisits to the hospital for six months after the treatment. The opticalcoherence tomography（OCT）, central macular thickness（CMT）, BestCorrected VisualAcuity（BCVA）and intraocular pressure（IOP）beforethe treatment and one week, one month, three-months and six-monthslater after the treatment were observed and recorded.Results：CMT: The CMT of patients in groupA measured at one week,one month, three months’ and six months’ after the treatment respectively reduced to346.4615±94.6032μm、319.8462±142.5879μm、300.2308±114.4852μm and280.1538±48.0136μm. In group B,the CMT measured at one week, one month, three months’ and sixmonths’ after the treatment respectively are lowered to466.0909±131.1613μm、487.8182±109.5014μm、419.0000±88.0682μm and374.1818±82.4364μ m. BCVA: The BCVA of patients in group Ameasured one week, one month, three months and six months later afterthe treatment respectively increased to0.3208±0.1352、0.3708±0.2088、0.4038±0.2321and0.3908±0.2084. In group B, the BCVAofpatients measured at one week, one month, three months and six monthslater after the treatment respectively are increased to0.1645±0.1210、0.2109±0.1618、0.1945±0.1317and0.2527±0.1374. The conditionsof patients in two groups at different period after the treatment and thedecrease of CMT compared with prior treatment period have greatstatistical significance （P<0.05）. Compared with the status before thetreatment, the BCVA improvement of patients in group A at differentperiod within the treatment have great statistical significance （P<0.05）.However, the compared with the status before the treatment, theimprovement of patients in group B at different period within thetreatment do not have any statistical significance （P<0.05）. Thepatients in group A didn’t have intraocular pressure increase during theentire treatment, while there is one patient in group B（5.26%）, whose intraocular pressure is higher than21mmHg. But no other complicationsoccurred among patients in two groups.Conclusion:1、By treating secondary macular edema of retinal vein occlusionwith lucentis intravitreal injection, the symptom of macular edema canbe significantly relieved and the patient’s vision can be improved aswell.2、Whether repeatedly injections are needed in treating secondarymacular edema of retinal vein occlusion with lucentis intravitrealinjection depends on the patient’s fundus status.更多还原