SD-OCT联合mf-ERG对康柏西普单次治疗nAMD的效果评价  

Evaluation of the efficacy of conbercept in single treatment of nAMD by SD-OCT in combination with mf-ERG

作　　者：王星[1] 刘彦尧 彭惠[1] Wang Xing;Liu Yanyao;Peng Hui(Department of Ophthalmology,The First Affiliated Hospital of Chongqing Medical University,Chongqing Key Laboratory of Ophthalmology,Chongqing Eye Institute)

机构地区：[1]重庆医科大学附属第一医院眼科、眼科学重庆市重点实验室、重庆市眼科研究所,重庆400016

出　　处：《重庆医科大学学报》2020年第2期179-183,共5页Journal of Chongqing Medical University

基　　金：国家自然科学基金面上资助项目(编号:81670881)。

摘　　要：目的:观察单次玻璃体腔注射康柏西普治疗渗出型年龄相关性黄斑变性(neovascular age-related macular degeneration,n AMD),通过光学相干断层扫描(spectral-domain optical coherence tomography,SD-OCT)及多焦视网膜电图(multifocal electroretinogram,mf-ERG)了解视网膜解剖与视网膜功能的相关性,评价康柏西普治疗nAMD的短期疗效,探讨mf-ERG作为预测疗效及优化治疗方案的价值。方法:回顾性收集nAMD患者36例36只眼,均接受玻璃体腔注射康柏西普0.05 mL/0.5 mg一次的治疗,记录治疗前及治疗后1个月时的最佳矫正视力(best corrected visual acuity,BCVA)、视网膜黄斑中央厚度(central retinal macular thickness,CRT)、以黄斑为中心1、3、6 mm圆内RPE隆起的容积(1RV、3RV、6RV),mf-ERG中R1环P1波振幅密度、潜伏期等数据资料。统计学分析采用SPSS 22.0软件,2组计量资料的差异比较采用两配对样本t检验,采用Pearson相关性分析评价黄斑区功能与结构的相关性,检验水准α=0.05。结果:36例36只眼经康柏西普治疗后较治疗前,平均BCVA提高(0.19±0.16 vs. 0.26±0.17);平均CRT下降[(472.14±181.53)μm vs.(389.5±124.79)μm];平均1RV下降[(0.36±0.14) mm^3 vs.(0.31±0.11) mm^3];平均3RV下降[(3.04±0.98) mm^3 vs.(2.59±0.71) mm^3],平均6RV下降[(8.17±2.91) mm^3 vs.(6.66±2.38) mm^3],差异均有统计学意义(P <0.01)。P1波振幅密度与治疗前的(36.47±14.25) nv/deg2相比,增加至(47.21±13.13) nv/deg2,差异有统计学意义(P<0.01),P1波潜伏期相比无明显改变[(38.13±9.75) ms vs.(39.21±9.62) ms],差异无统计学意义(P>0.05)。术前术后BCVA与CRT、1RV、3RV、6RV均呈显著负相关,与P1波振幅密度、潜伏期均呈显著正相关;术前术后CRT、3RV、6RV与P1波振幅密度均呈显著负相关,差异有统计学意义(P<0.05)。3例3只眼在注射后出现结膜下出血,治疗后均恢复正常,所有患者随访期间未见严重眼部及全身并发症。结论:康柏西普治疗nAMD短期疗效�Objective:To observe the effect of a single intravitreal injection of conbercept in the treatment of neovascular age-related macular degeneration(nAMD),to evaluate the short-term efficacy of conbercept in the treatment of nAMD through investigating the correlation between retinal anatomy and retinal function by spectral-domain optical coherence tomography(SD-OCT) and multifocal electroretinogram(mf-ERG),and to explore the value of mf-ERG in predicting therapeutic effect and optimizing therapeutic regimen.Methods:A retrospective analysis was conducted in 36 patients with nAMD(36 eyes). All patients were treated with a single intravitreal injection of conbercept 0.05 mL/0.5 mg. The best corrected visual acuity(BCVA),the central retinal macular thickness(CRT),the volume of RPE uplift in the 1,3,and 6 mm circles with the macula lutea as the center(1 RV,3 RV,6 RV),and the amplitude density and latency of P1 wave in mf-ERG R1 ring were recorded before and at 1 month after treatment. Statistical analysis was performed using SPSS 22.0 software. Continuous data were compared between two groups using the paired t-test,and the correlation between macular structure and function was evaluated by Pearson correlation analysis,with a test level of 0.05. Results:After treatment with conbercept in the 36 eyes of 36 patients,the mean BCVA significantly improved(0.19±0.16 vs. 0.26±0.17),the mean CRT significantly decreased[(472.14±181.53 ) μm vs.(389.5 ±124.79) μm],the mean 1 RV significantly decreased[(0.36±0.14) mm^3 vs.(0.31±0.11) mm^3],the mean 3 RV significantly decreased[(3.04±0.98) mm^3 vs.(2.59±0.71) mm^3],and the mean 6 RV significantly decreased[(8.17±2.91) mm^3 vs.(6.66±2.38) mm^3](all P<0.01). The amplitude density of P1 wave significantly increased from(36.47±14.25) nv/deg2 before treatment to(47.21±13.13) nv/deg2 after treatment(P<0.01),while the latency of P1 wave showed no significant change after treatment[(38.13±9.75) ms vs.(39.21±9.62) ms,P>0.05]. BCVA had a significant negative correlation with CR

关 键 词：多焦视网膜电图 光学相干断层扫描 渗出型年龄相关性黄斑变性 康柏西普 血管内皮生长因子 

分 类 号：R774[医药卫生—眼科]