光学相干断层扫描血管成像技术在康柏西普对湿性年龄相关性黄斑变性治疗效果评价中的临床研究  

Therapeutic effects of Conbercept on wet age-related macular degeneration using optical coherence tomography angiography

作　　者：段如月 张天资[1] 晓琴[1] 韩永青 佟玉兰[1] Duan Ruyue;Zhang Tianzi;Xiao Qin;Han Yongqing;Tong Yulan(Department of Ophthalmology,Affiliated Hospital of Inner Mongolia University for Nationalities,Tongliao 028000,China)

机构地区：[1]内蒙古民族大学附属医院眼科,通辽028000

出　　处：《中华眼科医学杂志（电子版）》2021年第3期140-145,共6页Chinese Journal of Ophthalmologic Medicine(Electronic Edition)

基　　金：内蒙古自治区自然科学基金项目[2017MS(LH)0822]。

摘　　要：目的利用光学相干断层扫描血管成像技术(OCTA)评估康柏西普治疗湿性年龄相关性黄斑变性(AMD)的疗效。方法收集2016年4月至2018年12月在内蒙古民族大学附属医院眼科诊断为湿性AMD的32例(40只眼)患者。其中,男性19例(23只眼),女性13例(17只眼);年龄54-83岁,平均年龄(68.0±7.5)岁。采用连续3次每月注射后改用按需的方案进行治疗。记录患者术前、术后1 d、3 d、7 d、1个月、2个月、3个月和6个月的最佳矫正视力(BCVA)、视网膜黄斑厚度(CMT)和脉络膜新生血管(CNV)面积。治疗前与治疗后不同时间点,患者的BCVA、CNV面积及CMT经过正态性检验,符合正态分布,采用均数±标准差进行描述,治疗前后的比较采用单因素重复测量方差分析,当差异有统计学意义时,进一步两两比较。结果湿性AMD的32例(40只眼)患者中1型CNV者10例(12只眼),占31.2%;2型CNV者22例(28只眼),占68.8%。湿性AMD 1型CNV和2型CNV者治疗后6个月黄斑区水肿渗出均较治疗前减少,荧光素渗漏均减少,黄斑区神经上皮层和视网膜色素上皮层间隆起距离均变小,新生血管有所消退。湿性AMD患眼治疗前BCVA、CNV面积及CMT分别为(0.78±0.46)、(1.56±0.92)mm^(2)、(304.73±121.27)μm;治疗后6个月分别为(0.51±0.35)、(1.18±0.79)mm^(2)、(235.90±62.18)μm。经单因素重复测量方差分析,不同时间点治疗前后BCVA、CNV面积及CMT比较的差异有统计学意义(F=6.878,6.952,5.365;P<0.05)。进一步比较,经t检验,患者治疗后6个月与治疗前BCVA、CNV面积及CMT比较的差异有统计学意义(t=4.19,3.96,3.58;P<0.05)。结论OCTA可以直观清晰地显示CNV病灶形态,并提供CMT和CNV面积等,能为湿性AMD的抗血管内皮细胞生长因子治疗和愈后评估提供参考。Objective The aim of this study is to evaluate the efficacy of Conbercept in the treatment of wet age-related macular degeneration(AMD)using the optical coherence tomography angiography(OCTA).Methods 32 patients(40 eyes)diagnosed with wet AMD from the Department of Ophthalmology,Affiliated Hospital of Inner Mongolia University for Nationalities from April 2016 to December 2018 were collected retrospectively.Among of them,there were 19 males(23 eyes)and 13 females(17 eyes);they were 54 to 83 years-old with an average age of(68.0±7.5)years-old.After 3 consecutive monthly injections,they were switched to an on-demand treatment plan for treatment.The patient′s preoperative,1 day,3 days,7 days,1 month,2 months,3 months and 6 months after the operation best corrected visual acuity(BCVA),fluorescein fundus angiography(FFA)leakage,retinal structure integrity,central macular thickness(CMT)and choroidal neovascularization(CNV)area were recorded.At different time points before and after treatment,BCVA,CNV area,and CMT were tested for normality and conformed to normal distribution.The mean±standard deviation was used for description.The comparison before and after treatment was used single-factor repeated measures analysis of variance.When the difference is statistically significant,further pairwise was comparised.Results Among of 32 cases(40 eyes)of wet AMD,there were 10 cases(12 eyes)with type 1 CNV,accounting for 31.2%;22 cases(28 eyes)with type 2 CNV,accounting for 68.8%.After treatment for 6 months,macular edema,exudation,fluorescein leakage,retinal pigment epithelium protrusion and neocapillaries subsided in wet AMD patients with type 1 CNV and type 2 CNV.The preoperative BCVA,CNV area and CMT of eyes with wet AMD were(0.78±0.46),(1.56±0.92)mm^(2),(304.73±121.27)μm,respectively;after treatment for 6 months,the BCVA,CNV area and CMT of eyes with wet AMD were(0.51±0.35),(1.18±0.79)mm^(2),(235.90±62.18)μm,respectively.There were significant differences in BCVA,CNV area and CMT before and after treatment at dif

关 键 词：光学相干断层扫描血管成像技术 湿性年龄相关性黄斑变性 康柏西普 脉络膜新生血管 疗效 

分 类 号：R774.5[医药卫生—眼科]