OCTA评价康柏西普对湿性年龄相关性黄斑变性的治疗效果  

Therapeutic effect of conbercept on wet age-related macular degeneration evaluated by OCTA

作　　者：杨主敏 黄星 刘淑卿 李娟娟[2] 王鲜 YANG Zhumin;HUANG Xin;LIU Shuqing;LI Juanjuan;WANG Xian(Department of Ophthalmology,the Affiliated Hospital of Guizhou Medical University,Guiyang 550004,Guizhou,China;Department of Ophthalmology,the Second People's Hospital of Yunnan Province,Kunming 650021,Yunnan,China)

机构地区：[1]贵州医科大学附属医院眼科,贵州贵阳550004 [2]云南省第二人民医院眼科,云南昆明650021

出　　处：《贵州医科大学学报》2021年第5期596-599,605,共5页Journal of Guizhou Medical University

基　　金：云南省眼科疾病防治研究重点实验室专项项目(2017DG008-1)。

摘　　要：目的采用光学相干断层扫描血管成像(OCTA)评价康柏西普对湿性年龄相关性黄斑变性(AMD)的治疗效果。方法选取接受康柏西普治疗的60例(68眼)湿性AMD患者作为研究对象,于治疗前及治疗后1个月时,采用WHO的视力分级标准检测患者的最佳矫正视力(BCVA),采用OCTA检测患眼的脉络膜新生血管面积(CNV)、中心凹浅层的黄斑厚度及血管血流密度、中心凹旁浅层的黄斑厚度及血管血流密度;采用免疫速率散射比浊法检测血清C反应蛋白(CRP)水平、ELISA法检测血清中血管内皮生长因子(VEGF)含量;观察治疗过程中视网膜脱离、玻璃体积血、医源性白内障等并发症发生率,采用治疗后1个月时阿姆斯勒方格表(Amsler表)检查以评价治疗效果。结果治疗后1个月时,68只患眼中视力提高60眼、视力下降2眼、视力稳定6眼,有效率为88.24%,患眼的BCVA视力较治疗前提高、眼压较治疗前下降(P<0.05),患眼的CNV较治疗前缩小,中心凹黄斑厚度、中心凹旁黄斑厚度、中心凹浅层血管血流密度也较治疗前减少(P<0.05),血清CRP、VEGF水平较治疗前下降(P<0.05);治疗过程中,68只患眼无视网膜脱离、玻璃体积血、医源性白内障等并发症发生;患者治疗后1个月时的Amsler表方格线条曲直性、粗细均匀性、清晰度变化总有效率为95.59%。结论康柏西普治疗湿性AMD,可有效改善患眼的视力和眼压,减轻炎症程度;OCTA可监测患眼的黄斑厚度、中心凹浅层血管血流密度变化。Objective To evaluate the Therapeutic effect of Conbercept on wet age-related macular degeneration(AMD)using optical coherence tomography angiography(OCTA).Methods Sixty patients(68 eyes)with AMD were recruited.Before the treatment and 1 month after treatment,WHO's visual acuity classification standards were used to examine the patients’best corrected visual acuity(BCVA).OCTA was used to detect eye choroidal neovascular area(CNV),the macular thickness and vascular blood flow density of the superficial fovea and parafovea.Serum C-reactive protein(CRP)level was detected using immuno-rate scattering turbidimetric method,and serum vascular endothelial growth factor(VEGF)content was detected by ELISA assay.Retinal detachment,vitreous hemorrhage,iatrogenic cataract,and other complications were observed during the treatment.The therapeutic effect of the treatment was evaluated using the Amsler checklist at 1 month after treatment.Results At 1 month after treatment,the visual acuity was improved in 60 eyes,decreased in 2 eyes,stable in 6 eyes.The effective rate was 88.24%.At 1 month after treatment,the BCVA visual acuity was increased,in contrast,eye pressure was decreased(P<0.05).Additionally,the CNV,foveal macular thickness,the parafoveal macular thickness,and the superficial foveal blood flow density were reduced(P<0.05).Serum CRP and VEGF levels were lower than before treatment(P<0.05).During the treatment,68 eyes had no complications such as retinal detachment,vitreous hemorrhage,and iatrogenic cataract.The total effective rate of the straightness,uniformity of thickness,and sharpness of the grid lines in the Amsler table was 95.59%.Conclusion Conbercept can effectively improve the visual acuity and intraocular pressure of eyes with AMD,and reduce the degree of inflammation.OCTA can monitor the changes of the macular thickness and the blood flow density of the superficial foveal vessel in eyes with AMD.

关 键 词：湿性黄斑变性 光学相干断层扫描血管成像 康柏西普 年龄相关性黄斑变性 炎症反应 视力 眼压 

分 类 号：R774.5[医药卫生—眼科]