康柏西普玻璃体内注射与其联合黄斑区激光光凝对糖尿病黄斑水肿的疗效比较  

Comparison of efficacy between intravitreal injection of conbercept with and without macular photocoagulation for diabetic macular edema

作　　者：蒋莉 罗小玲 秦波 邓铤明 杨明明 Jiang Li;Luo Xiaoling;Qin Bo;Deng Tingming;Yang Mingming(Department of Ophthalmology,Shenzhen People's Hospital,Second Clinical Medical College of Jinan University,The First Affiliated Hospital,Southern University of Science and Technology,Shenzhen 518020,China)

机构地区：[1]深圳市人民医院眼科,暨南大学第二临床医学院,南方科技大学第一附属医院,518020

出　　处：《中华实验眼科杂志》2022年第1期41-46,共6页Chinese Journal Of Experimental Ophthalmology

基　　金：深圳市卫生计生系统科研项目(SZFZ2017085)。

摘　　要：目的比较康柏西普玻璃体内注射与其联合黄斑区激光光凝在糖尿病黄斑水肿(DME)治疗中的效果及安全性。方法采用非随机对照研究方法,选取2017年1月至2020年1月于深圳市人民医院就诊的DME患者60例60眼,按照治疗方法不同,将仅接受康柏西普玻璃体内注射的患者33例33眼作为康柏西普注射组,将黄斑区视网膜光凝联合康柏西普玻璃体内注射的患者27例27眼作为联合治疗组,观察各组治疗前及治疗1、3、6、9和12个月时最佳矫正视力(BCVA)、黄斑中心凹厚度(CMT)及荧光素眼底血管造影(FFA)检查黄斑水肿及渗漏的范围变化,记录康柏西普注射次数并观察治疗期间眼部及全身不良反应的发生情况。结果2个组内患眼治疗1、3、6、9和12个月时平均BCVA均较治疗前明显提高,平均CMT均较治疗前明显降低,差异均有统计学意义(均P<0.05)。治疗6、9及12个月时联合治疗组BCVA较康柏西普注射组明显提高,CMT较康柏西普注射组明显降低,差异均有统计学意义(均P<0.05)。治疗12个月时FFA复查发现,康柏西普注射组黄斑水肿改善有效率为91.0%(30/33),低于联合治疗组的96.3%(26/27),差异有统计学意义(χ^(2)=3.430,P<0.05)。康柏西普注射组平均注射(4.36±1.62)次,明显多于联合治疗组的(3.41±0.64)次,差异有统计学意义(t=9.211,P<0.05)。所有病例治疗期间均未出现高眼压、眼内炎及视网膜色素上皮层撕裂等与治疗相关严重眼部及全身并发症。结论康柏西普玻璃体内注射或联合黄斑区激光光凝治疗DME均可有效稳定或提高患眼视力,改善黄斑水肿,安全性好,联合治疗的长期疗效优于单纯康柏西普玻璃体内注射治疗。Objective To compare the clinical efficiency and safety between intravitreal injection of conbercept with and without macular photocoagulation for diabetic macular edema(DME).Methods A non-random controlled study was conducted.Sixty patients(60 eyes)with DME treated in Shenzhen People's Hospital from January 2017 to January 2020 were enrolled.The patients receiving intravitreal injection of conbercept alone were divided into conbercept injection group(33 cases,33 eyes),and those who underwent macular photocoagulation combined with intravitreal injection of conbercept were divided into combined treatment group(27 cases,27 eyes).Best corrected visual acuity(BCVA)was examined using Early Treatment of Diabetic Retinopathy Study.The BCVA,central macular thickness(CMT)and fluorescein fundus angiography(FFA)examination were performed to observe the changes of macular edema and leakage area before and at 1,3,6,9 and 12 months after treatment.The injection frequency,ocular and systemic complications were recorded.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Shenzhen Pepole's Hospital(No.LL-YK-20170405).Written informed consent was obtained from each patient prior to any medical examination.Results There were better mean BCVA and lower CMT at 1,3,6,9 and 12 months after treatment compared with the BCVA and CMT before treatment in the two groups(all at P<0.05).At 12 months after treatment,FFA showed that the improvement rate of macular edema was 91.0%(30/33)in the conbercept injection group and 96.3%(26/27)in the combined treatment group,showing a statistically significant difference between them(χ^(2)=3.430,P<0.05).The injection frequency was(4.36±1.62)times in the conbercept injection group,which was significantly higher than(3.41±0.64)times in the combined treatment group(t=9.211,P<0.05).No ocular adverse events,including ocular hypertension,endophthalmitis and retinal pigment epithelial tears or systemic complications were found during the follow-up.Conclusions

关 键 词：黄斑水肿/治疗 激光光凝 康柏西普 玻璃体内注射 

分 类 号：R774.5[医药卫生—眼科] R587.2[医药卫生—临床医学]