摘要
目的探讨中心性渗出性脉络膜视网膜病变(CEC)合并脉络膜新生血管(CNV)患者连续2次玻璃体腔内注射抗新生血管药物Lucentis后,房水中VEGF含量变化与眼底病灶改善的相关性。方法 9例患眼经矫正视力、眼内压、光相干断层扫描(OCT)及眼底荧光造影(FFA+ICGA)检查确诊为CEC后,进行首次玻璃体腔内注射Lucentis,4周后进行第二次注射,每次注射时均抽取约0.1 ml房水,置-80℃冰箱中保存。采用酶联免疫吸附测定法对所有的房水进行VEGF含量的测定,并与视力和眼底病灶恢复的情况相比较,找出其相关性。结果中心性渗出性脉络膜视网膜病变患者房水中的VEGF在首次和第2次玻璃体腔内注射Lucentis时,其含量分别为(35.89.±3.75)pg/ml和(8.89±2.95)pg/ml,视力从基线0.33±0.08提高到眼内注射药物后1月及2月时的0.60±0.15和0.71±0.21,OCT中观察到眼内注射药后1月和2月CNV的面积明显缩小,眼内注射药后2个月FFA显示CNV处的渗漏基本消失。结论玻璃体腔内注射Lucentis后,可使CEC合并CNV患者短期内房水中VEGF含量降低,视力提高,眼底病灶明显好转。
Objective To explore the relations between the VEGF concentration of aqueous humor and improvement of fundus diseases after intravitreal injection of Lucentis in central exudative chorioretinopathy（CEC） patients. Methods Nine patients were diagnosed as CEC after correcting the vision by detecting intra-ocular pressure and fundus situation by optical coherence tomography （OCT） ,fundus fluorescein angiography （FFA） and indocyanine green angiography（ICGA）. Every diseased eye was intravitreally injected with Lucentis 0.5 mg/0.05 ml at the baseline and week 4. Aqueous humor was automatically sucked out about 0.1 ml from anterior chamber during the injetion in order to balance the intra-ocular pressure and preserved at refrigerator with minus 80 degrees. All aqueous humors were analyzed by enzyme-linked immunosorbent assay （ELISA）. VEGF concentration was detected by ELISA kit and visual acuity and shrinkage of fundus hemorrhage and CNV were determined before and after each injection by 3D - OCT and fundus angiography images,and their correlation was analyzed. Results VEGF concentration in aqueous humor at the baseline and the second injections were （35.89 ＋ 3.75 ）pg/ml and （8.89 ＋ 2.95 ）pg/ml. The visual acuity was improved from 0.33 ＋ 0.08 to 0.60 ＋ 0.15 at month 1 and 2 after the baseline injection. The obvious shrinkage of fundus hemorrhage and CNV by OCT and leakage of fundus CNV by FFA almost disappeared. Conclusion Intra-vitreal injection of Lucentis can decrease VEGF concentration, increase the vision acuity and improve the fundus diseases at short time.
出处
《山西医科大学学报》
CAS
2013年第11期892-895,918,F0003,共6页
Journal of Shanxi Medical University
基金
上海市科委基础重点基金资助项目(11JC1410600)
