康柏西普联合全视网膜激光光凝对缺血型视网膜中央静脉阻塞伴黄斑水肿患者视力预后及视网膜血流的影响  

Effect of conbercept combined with whole retina laser photocoagulation on visual prognosis and retinal blood flow in patients with ischemic central retinal vein occlusion with Macular edema

作　　者：李全兰 犹爱林 刘林殊 王一 Li Quanlan;You Ailin;Liu Linshu;Wang Yi(Department of Ophthalmology,the Chongqing Aier Eye Hospital,Chongqing 400000,China)

机构地区：[1]重庆爱尔眼科医院眼科,重庆400000

出　　处：《中国医师杂志》2023年第6期864-868,874,共6页Journal of Chinese Physician

基　　金：重庆市科卫联合医学科研项目(2021MSXM263)。

摘　　要：目的探讨康柏西普联合全视网膜激光光凝治疗缺血型视网膜中央静脉阻塞(iCRVO)伴黄斑水肿(ME)的临床疗效及其对患者视力预后和视网膜血流的影响。方法前瞻性选取重庆爱尔眼科医院2019年1月至2020年11月收治的80例(80眼)iCRVO伴ME患者,以随机数字表法分成两组,每组40例。其中观察组给予康柏西普联合全视网膜激光光凝治疗,对照组单用全视网膜激光光凝治疗。比较两组临床疗效及安全性。治疗前后检查两组患者的最佳矫正视力(BCVA)、中央黄斑厚度(CMT)以及视网膜血流参数[视网膜浅层毛细血管丛(SCP)血流密度、黄斑中心凹无血管区(FAZ)面积],采用低视力者生存质量量表(CLVQOL)评价患者治疗前后生活质量。结果观察组总有效率为95.00%(38/40),高于对照组的77.50%(31/40)(P<0.05)。两组治疗后1周、1个月、3个月时的BCVA均显著高于本组治疗前,CMT均显著低于本组治疗前(均P<0.05)。观察组治疗后1周、1个月、3个月时的BCVA均显著高于对照组同时点(均P<0.05),治疗后3个月时的CMT显著低于对照组同时点(均P<0.05)。两组治疗前后SCP血流密度、黄斑FAZ面积均无明显变化(均P>0.05)。观察组治疗后1周、1个月、3个月时的CLVQOL量表各维度评分及总分均较治疗前显著升高(均P<0.05)。对照组治疗后1周、1个月、3个月时的CLVQOL量表远视力、移动和光感、调节能力2个维度评分及总分均较治疗前显著升高(均P<0.05);治疗后1、3个月时的CLVQOL量表阅读及精细工作、日常生活能力2个维度评分均较治疗前显著升高(均P<0.05)。观察组治疗后1、3个月时的CLVQOL量表远视力、移动和光感、阅读及精细工作2个维度评分和总分均显著高于对照组同时点(均P<0.05);治疗后3个月时的CLVQOL量表调节能力维度评分显著高于对照组同时点(P<0.05)。两组治疗过程中均未见严重不良事件。结论康柏西普联合全视网膜激光光凝Objective To investigate the clinical efficacy of conbercept combined with whole retina laser photocoagulation in the treatment of ischemic central retinal vein occlusion(iCRVO)with macular edema(ME)and its effect on visual prognosis and retinal blood flow.Methods A prospective study was conducted on 80 patients(80 eyes)with iCRVO and ME admitted to the Chongqing Aier Eye Hospital from January 2019 to November 2020.They were randomly divided into two groups using a random number table method,with 40 patients in each group.Among them,the observation group was treated with conbercept combined with whole retina laser photocoagulation,while the control group was treated with whole retina laser photocoagulation alone.We compared the clinical efficacy and safety between two groups.Before and after treatment,the best corrected visual acuity(BCVA),central macular thickness(CMT),and retinal blood flow parameters[retinal superficial capillary plexus(SCP)blood flow density,and macular foveal avascular zone(FAZ)area]were examined in both groups of patients.The Low Vision Quality of Life Scale(CLVQOL)was used to evaluate the quality of life of patients before and after treatment.Results The total effective rate of the observation group was 95.00%(38/40),which was higher than 77.50%(31/40)of the control group(P<0.05).The BCVA at 1 week,1 month,and 3 months after treatment in both groups was significantly higher than that before treatment in this group,while the CMT was significantly lower than that before treatment in this group(all P<0.05).The BCVA of the observation group at 1 week,1 month,and 3 months after treatment was significantly higher than that of the control group at the same time point(all P<0.05),while the CMT of the observation group at 3 months after treatment was significantly lower than that of the control group at the same time point(all P<0.05).There were no significant changes in SCP blood flow density and macular FAZ area before and after treatment in both groups(all P>0.05).The CLVQOL scale scores and tot

关 键 词：激光凝固术 康柏西普 视网膜静脉闭塞 黄斑水肿 

分 类 号：R779.63[医药卫生—眼科]