玻璃体注射治疗糖尿病玻璃体切除术后复发性玻璃体出血

Pingli Zhu, Zhuoshi Wang, Liang-bao An, Ling-Xian Xu
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摘要

目的探讨玻璃体内孕术治疗玻璃体切除术后迟发性(术后4周)糖尿病性玻璃体出血(PVDVH)的疗效。方法将36例延迟性PVDVH患者(36眼)连续分为研究组(17眼)和对照组(19眼)两组。研究组给予玻璃体内注射,无明显血液吸收者,4周后再次注射,直至血液完全吸收。对照组给予中药和碘化卵磷脂治疗。平均随访时间8.5±2.5个月(5~13个月)。结果研究组VCT时间为2 ~ 8周,平均5.3±2.3周,平均注射2.2±0.8次。4只眼发生复发性玻璃体出血(VH),但研究结束时所有眼玻璃体均清晰,无需玻璃体切除手术。对照组在3 ~ 9周内自发重吸收8只眼,平均6.7±2.5周,复发性VH 11只眼,最终1只眼血液被吸收,10只眼持续性VH, 4只眼虹膜神经血管形成,4只眼视网膜脱离,最后这10只眼行玻璃体切除术。研究组的视力优于对照组。结论玻璃体体外受精治疗可加速VH的清除,减少并发症,减少PVDVH的手术需要。关键词:概念;糖尿病视网膜病变;复发性玻璃体出血
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Intravitreal conbercept injection for recurrent vitreous haemorrhage after diabetic vitrectomy
Objective To assess the effects of intravitreal conbercept in treating delayed post-vitrectomy (4 weeks after surgery) diabetic vitreous hemorrhage (PVDVH). Methods Of 36 consecu-tive patients (36 eyes) with delayed PVDVH were assigned to tow groups, the study group (17 eyes) and the control group (19 eyes). The study group was treated with intravitreal conbercept, and repeated injection was given after 4 weeks in cases with no obvious blood absorption, until the blood was absorbed completely. The control group was given Chinese traditional medicine and iodized lecithin. The average follow-up duration was 8.5±2.5 months (ranged, 5~13 months). Results VCT of the study group was 2-8 weeks, mean 5.3±2.3 weeks, with average injection 2.2±0.8 times. Four eyes had developed recurrent vitreous hemorrhage (VH), but all of the eyes had a clear vitreous at the end of study period, and no vitrectomy surgery was needed. In the control group, eight eyes had spontaneous reabsorption in 3-9 weeks, mean 6.7±2.5 weeks, 11 eyes developed recurrent VH, the blood of one eye finally had been absorbed, 10 eyes had persistent VH, 4 eyes of them had iris neouvasculrization, and 4 eyes of them had retinal detachment, and finally these 10 eyes underwent revitrectomy surgeries. The vision of the study group was better than that in the control group. Conclusions Intravitreal conbercept treatment can accelerate the clear-up of the VH, reduce the complication and the need of revitrectomy for PVDVH. Key words: Conbercept; Diabetic retinopathy; Recurrent vitreous haemorrhage
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