康柏西普玻璃体腔注射联合激光光凝对糖尿病黄斑水肿患者脉络膜厚度的影响  

Clinical observation of intravitreal injection of Conbercept combined with laser photocoagulation for diabetic macular edema

作　　者：刘彦[1] 陈建华[1] 赵慧英[1] 吴香丽[1] 殷英霞[1] 陈冬军[1] LIU Yan;CHEN Jianhua;ZHAO Huiying(Department of Ophthalmology,Beijing Geriatric Hospital,Beijing 100095)

机构地区：[1]北京老年医院眼科

出　　处：《陕西医学杂志》2019年第8期1063-1065,1073,共4页Shaanxi Medical Journal

摘　　要：目的:观察玻璃体腔注射康柏西普联合激光光凝治疗对糖尿病黄斑水肿(DME)患者脉络膜厚度的影响。方法:将光学相干断层扫描、眼底荧光血管造影诊断为糖尿病黄斑水肿的患者56例(63只眼),随机分为两组:联合治疗组30例(32只眼),激光治疗组26例(31只眼)。联合治疗组先给予玻璃体腔注射康柏西普,1周后行黄斑区格栅光凝治疗,激光治疗组行黄斑区格栅治疗。两组中、重度非增殖性糖尿病视网膜病变(NPDR)及增殖性糖尿病视网膜病变(PDR)患者行全视网膜激光光凝术(PRP)治疗。在治疗后1个月,3个月,6个月观察黄斑中心凹下脉络膜厚度(SFCT),同时观察最佳矫正视力(BCVA)及黄斑中心凹厚度(CMT)。分析黄斑中心凹下脉络膜厚度变化与最佳矫正视力和黄斑中心凹厚度变化的关系。结果:术后1个月,3个月,6个月两组的黄斑中心凹下脉络膜厚度与术前比较均降低,差异均具有统计学意义(P<0.05);最佳矫正视力(BCVA)与术前比较均提高,差异均具有统计学意义(P<0.05);CMT与术前比较均降低,差异均具有统计学意义(P<0.05)。术后1个月,联合治疗组SFCT低于单纯激光组,差异具有统计学意义(P<0.05);术后1个月,3个月联合治疗组的BCVA高于单纯激光组,差异具有统计学意义(P<0.05),联合治疗组CMT低于单纯激光组,差异具有统计学意义(P<0.05)。结论:玻璃体腔内注射康柏西普联合激光治疗糖尿病黄斑水肿,短期内脉络膜厚度明显降低,脉络膜厚度的变化可在一定程度上评估糖尿病黄斑水肿的治疗效果。Objective:To observe the changes of choroidal thickness after intravitreal injection of Conbercept combined with laser photocoagulation for diabetic macular edema.Methods:56 patients(63 eyes)with DME were enrolled in this study,according to fundus fluorescein angiography(FFA)and optical coherence tomography(OCT).The patients were divided into two groups:30 people(32 eyes)were taken as the macular grid photocoagulation combination with Conbercept therapy,26 people(31 eyes)were taken as the macular grid photocoagulation.Severe noproliferative diabetic retinopathy patients and proliferative diabetic retinopathy patients were taken as panretinal photocoagulation. The best corrected visual acuity(BCVA),central macular thickness(CMT), and subfoveal choroidal thickness(SFCT) were observed after operation in 1 months,3 months and 6 months.Results:The BCVA were improved in both groups after operation in 1 months,3 months and 6 months(P<0.05).The macular thickness(CMT) and subfoveal choroidal thickness(SFCT) were reduced in both groups after operation in 1 months,3 months and 6 months(P<0.05).BCVA were improved in combination group compared to laser group after operation in 1 months,3 months. The macular thickness(CMT) were reduced in combination group compared to laser group after operation in 1 months,3 months(P<0.05).Subfoveal choroidal thickness(SFCT) were reduced in combination group compared to laser group after operation in 1 months(P<0.05).Conclusion:Subfoveal choroidal thickness had significant reduction for diabetic macular edema with intravitreal injection of conbercept combined with laser photocoagulation in a short time. The changes of choroidal thickness can evaluate treatment effect for diabetic macular edema.

关 键 词：糖尿病黄斑水肿 治疗 康柏西普 视网膜激光光凝 脉络膜厚度 最佳矫正视力 

分 类 号：R774.5[医药卫生—眼科]