2002-2016年北京同仁医院新生血管性青光眼原发病因及治疗方式的变化趋势

doi:DOI：10. 13281/j. cnki. issn.1004-4469. 2019. 01. 003

眼科

2002-2016年北京同仁医院新生血管性青光眼原发病因及治疗方式的变化趋势

乔春艳邵蕾许欣悦杜秀娟杨晓晗曹凯刘涛

100730首都医科大学附属北京同仁医院北京同仁眼科中心眼科学与视觉科学北京市重点实验室北京市眼科研究所（乔春艳、邵蕾、许欣悦、杨晓晗、曹凯、刘涛）；250002山东中医药大学附属眼科医院（杜秀娟）

收稿日期:2019-01-05 出版日期:2019-01-25 发布日期:2019-01-29
通讯作者: 乔春艳，Email：chunyan_qiao@163.com
基金资助:
国家自然科学基金（81570837）

Etiological and clinical therapeutic changes trend of neovascular glaucoma in Beijing Tongren Hospital from 2002 to 2016

QIAO Chun-yan1, SHAO Lei1, XU Xin-yue1, DU Xiu-juan2, YANG Xiao-han1, CAO Kai1, LIU Tao1.

1. Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; 2.Ophthalmic Hospital Affiliated to Shandong University of Chinese Medicine, Jinan 250002, China

Received:2019-01-05 Online:2019-01-25 Published:2019-01-29
Contact: QIAO Chun-yan, Email: chunyan_qiao@163.com

摘要/Abstract

摘要：

目的分析新生血管性青光眼（neovascular glaucoma，NVG）2002-2016年病因及治疗方式的变化趋势。设计回顾性病例系列。研究对象 2002-2016年北京同仁医院住院治疗的NVG患者。方法回顾2002年1月1日-2016年12月31日住院治疗的NVG患者1094例（1152眼）的病历资料。分析2002-2006年及2012-2016年两组患者的年龄、性别、病因构成比；并且分析2013年前后NVG手术治疗方式构成比。主要指标 病因构成比、手术方式构成比。结果 2002-2006年组（121例）及 2012-2016年组（486例）糖尿病视网膜病变均为首要原发病（54.5%和52.1%）；视网膜静脉阻塞其次（33.1%和26.7%）。2012-2016年组中视网膜中央动脉阻塞、眼内肿瘤病例明显增多。儿童NVG最常见原发病是Coats病（36.4%）。2013年前睫状体破坏性手术最多（37.2%），2013年后下降到18.1%（χ2=53.997，P=0.000）；玻璃体注射抗VEGF药物从2.9%上升到45.1%（χ2=246.599，P=0.000）。外滤过手术治疗者从32.6%下降到16.6%（χ2=39.714，P=0.000），视网膜光凝或冷凝联合睫状体破坏类手术者从11.1%下降到2.2%（χ2=38.495，P=0.000）。去除单纯行玻璃体注射抗VEGF药物者，2013年前、2013年后，睫状体破坏性手术均居于首位，其次为外滤过手术，变化均无显著差异。结论 2002-2016年15年间北京同仁医院NVG住院患者人口学特征和原发病因未发生明显变化。首要病因均为糖尿病视网膜病变，其次为视网膜静脉阻塞。随着抗VEGF药物临床应用，NVG治疗策略发生巨大变化，抗VEGF治疗取代睫状体破坏类手术成为首位初始治疗方式；睫状体破坏和外引流手术有下降趋势但仍是目前治疗NVG的重要手术方式。（眼科，2019, 28： 11-16）

关键词: 新生血管性青光眼, 病因, 构成比, 抗VEGF治疗

Abstract:

Objective To investigate clinical etiological and therapeutic changes trend of neovascular glaucoma(NVG) from 2002 to 2016. Design Retrospective case series. Participants the NVG inpatients in Beijing Tongren Hospital from 2002 to 2016. Methods Totally 1094 cases (1152 eyes) of consecutive NVG inpatients were enrolled and reviewed. The gender, age, etiology were compared between two periods (in 2002-2006 and in 2012-2016). For therapeutic analysis, taking 2013 as a key point when anti-VEGF drugs were widely used, operation method of NVG was analyzed. Main Outcome Measures the constituent ratio of etiological and operative methods. Results The first clinical etiology of NVG both in 2002-2006 group (121 cases) and in 2012-2016 group (486 cases) were diabetic retinopathy (54.5%, 52.1%), followed by retinal vein occlusion (33.1% , 26.7%). Cases of central retinal artery occlusion and intraocular tumor increased significantly in 2012-2016. Coats disease (36.4%) was the most common original disease in children. Cyclodestructive procedures were the most popular (37.2%) before 2013, then significantly decreased to 18.1% (χ2=53.997, P=0.000), while vitreous injection of anti-VEGF drugs were the first therapy after 2013, of which composition ratio increased from 2.9% to 45.1% (χ2=246.599, P=0.000). External filtration was decreased from 32.6% to 16.6% (χ2=38.495, P=0.000), and retinal photocoagulation or condensation combined ciliary body damage was decreased from 11.1% to 2.2% (χ2=38.495, P=0.000). If the cases of simple vitreous anti-VEGF drugs were removed, the first therapy was ciliary body destructive surgery in both periods, and the second was external filtration(all P>0.05). Conclusion The clinical demographic characteristics and etiological change trend of NVG in 2002-2016 don’t change too much. The first etiology of NVG is diabetic retinopathy, followed by retinal vein occlusion. As the clinical application of anti-VEGF drugs, the cases accepted anti-VEGF treatment are significantly increased, and becomes the first therapy of NVG instead of ciliary body destructive surgery. The ciliary body destructive surgery and trabeculectomy were decreased, but are still main operation methods. (Ophthalmol CHN, 2019, 28: 11-16)

Key words: neovascular glaucoma, etiology, constituent ratio；anti-VEGF

乔春艳邵蕾许欣悦杜秀娟杨晓晗曹凯刘涛. 2002-2016年北京同仁医院新生血管性青光眼原发病因及治疗方式的变化趋势[J]. 眼科, doi: DOI：10. 13281/j. cnki. issn.1004-4469. 2019. 01. 003.

QIAO Chun-yan1, SHAO Lei1, XU Xin-yue1, DU Xiu-juan2, YANG Xiao-han1, CAO Kai1, LIU Tao1. . Etiological and clinical therapeutic changes trend of neovascular glaucoma in Beijing Tongren Hospital from 2002 to 2016[J]. Ophthalmology in China, doi: DOI：10. 13281/j. cnki. issn.1004-4469. 2019. 01. 003.

[1]	傅亚博. 颈内动脉起始段狭窄致眼缺血综合征一例[J]. 眼科, 2023, 32(5): 438-439.
[2]	周孟田朱树青李昊宇陈琪许淑霞, 解彦茜, 乐融融, 王小洁, 张绍丹, 梁远波, . 小梁切除术联合前房增殖膜拦截技术治疗新生血管性青光眼的有效性和安全性[J]. 眼科, 2023, 32(1): 21-26.
[3]	沈降华超群楼红王鹏赟龙永华. 新冠肺炎疫情前后急性共同性内斜视和间歇性外斜视住院手术构成比的变化[J]. 眼科, 2022, 31(6): 454-457.
[4]	李毅斌. 抗VEGF时代激光视网膜光凝在视网膜静脉阻塞临床管理中的价值[J]. 眼科, 2022, 31(3): 165-168.
[5]	庞睿奇王悦范肃洁曾流芝孙云晓郭奕钦李茹月曹凯王宁利. 多层级专科门诊中开角型青光眼亚型分布与人口学特征研究[J]. 眼科, 2022, 31(1): 8-13.
[6]	乔春艳张慧李健王倩张举侯芳章征桑景荭牟大鹏刘克高曹凯尤慕西田玮魏文斌王宁利. 新冠疫情对眼科急诊疾病构成的影响[J]. 眼科, 2022, 31(1): 45-50.
[7]	江汉秋彭静婷崔世磊马中华岳常丽赵娟刘雪菲李文文王佳伟. 首诊于眼科的成人非创伤性霍纳综合征临床特点及病因分析[J]. 眼科, 2021, 30(2): 112-117.
[8]	李毅斌. 抗VEGF时代糖尿病视网膜病变治疗的策略和发展方向[J]. 眼科, 2019, 28(4): 245-248.
[9]	叶琴林毓妮姚贻华朱益华. 巩膜长隧道法Ahmed阀植入术治疗新生血管性青光眼的一年效果观察[J]. 眼科, 2019, 28(1): 34-38.
[10]	王雪琼李军周欢粉宋宏鲁刘洪娟魏世辉徐全刚. 单中心神经眼科住院患者疾病构成比分析[J]. 眼科, 2018, 27(5): 381-385.
[11]	丁静文孙华李冬梅. 获得性泪点阻塞病因分析及手术治疗[J]. 眼科, 2018, 27(3): 192-195.
[12]	李林，史翔宇，韩崧，刘毅，周军，刘宁朴，卢海. 170例儿童眼内异物患者的致病原因、临床特征及预后分析[J]. 眼科, 2018, 27(2): 150-154.
[13]	马丹丹，曹凯，肖媛媛，孙镝，李毅斌. 预测视网膜静脉阻塞继发黄斑水肿抗VEGF治疗后视力的形态学指标分析[J]. 眼科, 2018, 27(2): 111-115.
[14]	傅博张绍丹孙晶李若溪刘驰王海林. 沈阳地区2011-2016年青光眼住院患者构成及特点分析[J]. 眼科, 2018, 27(1): 21-25.
[15]	闫玮玉李建军徐亮赵晶徐捷刘丽娟王立波. 2014-2016年北京同仁医院青光眼专科门诊青光眼类型构成比分析[J]. 眼科, 2017, 26(4): 234-237.

2002-2016年北京同仁医院新生血管性青光眼原发病因及治疗方式的变化趋势

Etiological and clinical therapeutic changes trend of neovascular glaucoma in Beijing Tongren Hospital from 2002 to 2016

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价