康柏西普治疗湿性年龄相关性黄斑变性患者应答反应的临床观察  

Clinical observation of Conbercept in the treatment of patients with wet age-related macular degeneration

作　　者：张司[1] 李青[1] 陈晖[1] Si Zhang;Qing Li;Hui Chen(Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing NingYi Eye Center, Nanjing 210008, Jiangsu Province, China)

机构地区：[1]南京大学医学院附属鼓楼医院,南京宁益眼科中心,中国江苏省南京市210008

出　　处：《国际眼科杂志》2020年第5期787-790,共4页International Eye Science

摘　　要：目的:观察康柏西普治疗湿性年龄相关性黄斑变性(wARMD)患者产生不同应答反应的临床特点及影响因素。方法:回顾性分析2018-01/09于我院行康柏西普玻璃体腔注射(3+PRN)的wARMD患者56例62眼的临床资料。治疗前后均进行最佳矫正视力(BCVA)和光学相干断层扫描(OCT)检查,根据注射3次后1mo BCVA情况评估应答反应并进行分组,BCVA提高≥5个字母者33例35眼纳入有应答组,余23例27眼纳入无应答组,分析两组患者治疗前后BCVA、中心视网膜厚度(CRT)情况及相关资料。结果:注射3次后1mo,有应答组患者BCVA从基线时41.83±7.92个字母提高到52.52±10.61个字母(t=-6.883,P=0.02),无应答组患者BCVA从基线时43.65±10.42个字母提高到44.18±8.47个字母(t=0.471,P=0.684),且治疗后两组患者CRT均较基线有不同程度下降(F=31.47、27.28,均P<0.01)。基线时,有应答组患者中黄斑中心凹下椭圆体带较完整者比例(69%)明显多于无应答组(7%),存在视网膜下液者比例(86%)高于无应答组(44%),存在视网膜内液者比例(31%)低于无应答组(81%)(均P<0.05),但两组患者存在色素上皮脱离者比例无差异(77%vs 59%,P>0.05)。结论:康柏西普可有效减少wARMD患者视网膜下积液和视网膜内积液,不同程度改善患者视力,视网膜外层结构(尤其是椭圆体带)的完整性及存在视网膜下积液的患者治疗后应答反应较好,而存在视网膜内积液患者治疗后应答反应不佳。·AIM:To observe the clinical characteristics and influence factors of different responses in patients with wet age-related macular degeneration(wARMD)treated with intravitreal conbercept.·METHODS:A total of 62 eyes(56 patients)with wet age-related macular degeneration who received intravitreal Conbercept injections(3+PRN)in our hospital from January to September 2018 were retrospectively analyzed.The best-corrected visual acuity(BCVA)and optical coherence tomography(OCT)were performed before and after treatment.Responses were evaluated and grouped according to BCVA after the last injection.33 cases of 35 eyes with BCVA improvement≥5 letters were included in the response group.23 cases with 27 eyes were included in the non-response group.Before and after treatment,BCVA,central retinal thickness(CRT)and related data of the two groups were analyzed.·RESULTS:One month after 3 injections,BCVA in the response group increased from 41.83±7.92 letters at baseline to 52.52±10.61 letters(t=-6.883,P=0.02),and BCVA increased from 43.65±10.42 letters at baseline to 44.18±8.47 letters in the non-response group(t=0.471,P=0.684).CRT of the two groups after treatment decreased from the baseline(F=31.47,27.28,all P<0.01).Six months after 3 injections,the proportion of patients with the integrity of the macular fovea ellipsoid in response group(69%)was more than that in the non-responsive group(7%),and the proportion of patients with subretinal fluid(86%)was higher than that without SRF in the response group(44%),the proportion of patients with intraretinal fluid(31%)in the response group was lower than that in the non-response group(81%)(all P<0.05),but there was no difference in the proportion of patients with pigment epithelial detachment between the two groups(77%vs 59%,P>0.05).·CONCLUSION:Intravitreal injections of conbercept can effectively reduce the subretinal fluid and retinal fluid in patients with wet age-related macular degeneration,and improve the patient's visual acuity.Patients with the integrity of the oute

关 键 词：康柏西普 湿性年龄相关性黄斑变性 中心视网膜厚度 应答反应 影响因素 

分 类 号：R51[医药卫生—内科学]