玻璃体注射康柏西普对新生血管性老年性黄斑变性患眼脉络膜厚度的短期影响  

Short-term effects of intravitreous Conbercept injection on choroid thickness in neovascular age-related macular degeneration eyes

作　　者：佘重阳 焦剑[1] 王婧[1] 卢弘[1] 华文[1] She Chongyang;Jiao Jian;Wang Jing;Lu Hong;Hua Wen(Department of Ophthalmology,Beijing Chao-Yang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院眼科,北京100020

出　　处：《眼科》2023年第6期478-482,共5页Ophthalmology in China

基　　金：国家自然科学基金青年科学基金(62206185)。

摘　　要：目的评估玻璃体注射康柏西普对新生血管性老年性黄斑变性患眼的眼压、视网膜厚度和脉络膜厚度的短期影响。设计前瞻性队列研究。研究对象收集2020年10月至2021年5月期间由同一医生行玻璃体注射0.05 ml康柏西普治疗的新生血管性老年性黄斑变性(nAMD)患者42例。方法所有受试者都进行一般眼科检查,使用IOL Master测量术前眼轴。观察术前1小时内、术后1小时、24小时,中心子区厚度(CFT)、视网膜神经纤维层(RNFL)厚度、中心凹下脉络膜厚度(SFCT)和旁中心凹脉络膜厚度(PFCT)的变化,并通过多元线性回归分析术前1小时内SFCT和PFCT的相关因素。主要指标CFT、RNFL厚度、SFCT、PFCT。结果注药前患者IOP为(15.8±3.6)mmHg,注药后1小时为(17.8±4.3)mmHg,注药后24小时为(13.8±2.6)mmHg,注药后IOP先显著升高后显著降低(F=5.43,P=0.006);注药前患者PFCT为(244.2±78.8)μm,注药后1小时为(197.3±84.1)μm,注药后24小时为(307.9±74.2)μm,注药后PFCT先显著降低后显著升高(F=3.48,P=0.04)。注药前、注药后1小时及注药后24小时,患者CFT(F=0.19,P=0.83)、RNFL(F=0.45,P=0.64)和SFCT(F=1.53,P=0.23)均无明显差异。SFCT[B(95%CI):-7.77(-12.25,-3.29),P=0.002]和PFCT[B(95%CI):-6.87(-10.51,-3.23),P=0.005]均与年龄负相关。结论玻璃体注射康柏西普对脉络膜厚度在短期内即有影响,可能导致短暂的脉络膜缺血,术后24小时即可恢复。Objective To evaluate the short-term effects of intravitreal Conbercept injection(ICI)on intraocular pressure(IOP),retinal thickness,and choroidal thickness.Design Prospective cohort study.Participants A total of 42 patients with neovascular age-related macular degeneration treated with 0.05 ml intravitreal Conbercept injection(ICI)by the same physician between October 2020 and May 2021 were collected.Methods All subjects underwent general physical and ophthalmic examinations.Eye axial length(AL)was measured using IOL Master before ICI.To observe the changes of central subfoveal thickness(CFT),retinal nerve fibre layer(RNFL)thickness,subfoveal choroidal thickness(SFCT)and parafoveal choroidal thickness(PFCT)within 1 hour before ICI,1 hour after ICI,and 24 hours after ICI.Factors associated with SFCT and PFCT measured within 1 hour before ICI were analyzed by multiple linear regression.Main Outcome Measures CFT,RNFL thickness,SFCT,PFCT.Results The IOP was 15.8±3.6 mmHg before the injection,17.8±4.3 mmHg at 1 hour after the injection,and 13.8±2.6 mmHg at 24 hours after the injection,with a significant increase followed by a significant decrease after ICI(F=5.43,P=0.006).The PFCT was 244.2±78.8μm before the injection,197.3±84.1μm at 1 hour after ICI,and 307.9±74.2μm at 24 hours after ICI,with a significant decrease followed by a significant increase after ICI(F=3.48,P=0.04).There were no significant differences in CFT(F=0.19,P=0.83),RNFL(F=0.45,P=0.64)and SFCT(F=1.53,P=0.23)among the different time point before and after ICI.Both SFCT[B(95%CI):-7.77(-12.25,-3.29),P=0.002]and PFCT[B(95%CI):-6.87(-10.51,-3.23),P=0.005]were negatively associated with age.Conclusion ICI has an immediate effect on choroidal thickness in the short term,which may lead to transient choroidal ischemia that recovers 24 hours after ICI.

关 键 词：玻璃体康柏西普 眼压 脉络膜厚度 

分 类 号：R774.5[医药卫生—眼科]