玻璃体切除术联合抗VEGF药物及视网膜光凝治疗增生型糖尿病视网膜病变的远期效果研究
Long term efficacy of vitrectomy combined with anti-VEGF drugs and retinal photocoagulation on proliferative diabetic retinopathy
范志华 1高雪霞 1孔晓路 1田野 1李铮1
作者信息
- 1. 郑州市第二人民医院眼科,郑州 450000
- 折叠
摘要
目的 评价玻璃体切除术后联合抗血管内皮生长因子(VEGF)药物及视网膜光凝术对增生型糖尿病视网膜病变(PDR)的远期疗效.方法 回顾性病例对照研究.收集郑州市第二人民医院2021年9月至2022年7月行玻璃体切除术的PDR患者75例(75眼).根据治疗方法分为两组:治疗组45例(45眼)玻璃体切除术后1个月行玻璃体腔注射抗VEGF药物联合荧光素眼底血管造影(FFA)辅助下视网膜光凝;对照组30例(30眼)仅行玻璃体切除术.两组均于玻璃体切除术前3～5 d行玻璃体内抗VEGF药物注射.观察术前及术后视力(logMAR)、眼压、玻璃体积血、新生血管性青光眼等,并进行对比分析.结果 术后1周及3个月:治疗组视力为0.67±0.25及0.31±0.12,对照组视力为0.75±0.34和0.61±0.16,术后1周两组视力差异无统计学意义(t=1.60,P=0.210),术后3个月治疗组视力明显优于对照组,差异有统计学意义(t=89.80,P＜0.001).随诊期间治疗组有2眼(4.4％)发生玻璃体积血,少于对照组的9眼(30.0％)(x2=9.39,P=0.002);术后3个月仅对照组7眼(23.3％)出现新生血管性青光眼.术后3个月对照组眼压(23.53±9.84)mmHg(1 mmHg=0.133 kPa),治疗组眼压(16.24±2.29)mmHg,差异有统计学意义(t=22.98,P＜0.001).结论 玻璃体切除术后联合抗VEGF药物治疗及补充视网膜光凝,能显著降低PDR患者术后严重并发症,促进视力的恢复.
Abstract
Objective To evaluate the long-term efficacy of vitrectomy combined with anti vascular endothelial growth factor(VEGF)drugs and retinal photocoagulation on proliferative diabetic retinopathy(PDR).Methods This was a retrospective case-control study.A total of 75 eyes of 75 PDR patients who underwent vitrectomy in Zhengzhou the Second People's Hospital from Sep.2021 to Jul.2022 were collected and all cases were divided into two groups,based on treatment methods.In the treatment group 45 patients(45 eyes)received intravitreal injection of anti-VEGF drugs and retinal photocoagulation with fluorescein fundus angiography(FFA)at 1 month after vitrectomy,and 30 patients(30 eyes)in the control group received vitrectomy only.Both groups received intravitreal injection anti-VEGF drugs at 3-5 days before surgery.Postoperative visual acuity(logMAR),intraocular pressure,vitreous hemorrhage,and neovascular glaucoma were observed and compared.Results At 1 week and 3 months after surgery,the visual acuity of the treatment group was 0.67±0.25 and 0.31±0.12,while the visual acuity of the control group was 0.75±0.34 and 0.61±0.16.There was no difference in visual acuity between the two groups at 1 week after surgery(t=1.60,P=0.210).The visual acuity of the treatment group was significantly better than that of the control group at 3 months after surgery(t=89.80,P＜0.001).During the follow-up period,2 eyes(4.4％)in the treatment group developed vitreous hemorrhage,which was lower than the 9 eyes(30.0％)in the control group(X2=9.39,P=0.002).At 3 months after surgery,there were 7 eyes(23.3％)in the control group with neovascular glaucoma.At 3 months after surgery,there was statistically significant difference in intraocular pressure between the control group(23.53±9.84)mmHg(1 mmHg=0.133 kPa)and the treatment group(16.24±2.29)mmHg(t=22.98,P＜0.001).Conclusion The combination of anti-VEGF drug and retinal photocoagulation after vitrectomy can significantly reduce postoperative complications in PDR patients and promote visual recovery.
关键词
抗血管内皮生长因子/增生型糖尿病视网膜病变/玻璃体积血/青光眼,新生血管/玻璃体切除术Key words
Anti vascular endothelial growth factor/Proliferative diabetic retinopathy/Vitreous hemorrhage/Glaucoma,neovascularization/Vitrectomy引用本文复制引用
出版年
2024
NETL
NSTL
万方数据