康柏西普联合激光光凝治疗非缺血型BRVO继发黄斑水肿

Effect of Conbercept injection and macular grid pattern photocoagulation in treating macular edema after non-ischemic branch retinal vein occlusion

摘要:

目的：观察玻璃体腔注射康柏西普联合视网膜黄斑格栅样激光光凝治疗非缺血型视网膜分支静脉阻塞(branch retinal vein occlusion，BRVO)继发黄斑水肿的疗效及安全性。

方法：采用回顾性病例研究，将临床检查确诊的非缺血型BRVO继发黄斑水肿患者38例38眼纳入研究。所有患者均行玻璃体腔注射康柏西普联合视网膜黄斑格栅样激光光凝治疗，所有患者在治疗前及治疗后均行最佳矫正视力(best corrected visual acuity，BCVA)、裂隙灯显微镜联合78D前置镜、眼压、光相干断层扫描、荧光素眼底血管造影检查，对比观察患者治疗前与治疗后1wk，1、2、3、6、9、12mo患眼BCVA和黄斑中心视网膜厚度(central macular thickness，CMT)的变化，记录患者与注药相关的不良反应和并发症情况。

结果：治疗前及治疗后1wk，1、2、3、6、9、12mo时患眼BCVA分别为0.89±0.62、0.64±0.59、0.55±0.62、0.46±0.43、0.53±0.67、0.43±0.38、0.42±0.29、0.40±0.30； 与治疗前相比，治疗后各时间点患眼BCVA明显提高，差异有统计学意义(P<0.001)； 联合治疗后各时间点两两比较，差异均无统计学意义(P>0.05)。治疗前及治疗后1wk，1、2、3、6、9、12mo时患眼CMT分别为683.25±236.47、298.65±116.12、276.89±107.28、281.55±99.62、251.41±119.47、240.58±88.62、231.74±75.36、209.51±84.68μm； 与治疗前相比，治疗后各时间点患眼CMT明显降低，差异有统计学意义(P<0.001)； 治疗后各时间点相互比较，差异无统计学意义(P>0.05)。注射1次者11眼，注射2次者18眼，注射3次者2眼，注射4次者3眼，>4次者4眼，平均玻璃体腔注药次数为2.01±1.42次，再次注射后CMT厚度较注射前降低。随访期间未发生与药物及玻璃体注射相关的眼部和全身并发症。

结论：玻璃体腔注射康柏西普联合视网膜黄斑格栅样激光光凝可以用于治疗非缺血型BRVO，其可促进黄斑水肿吸收，有效地提高患眼视力，疗效显著，安全性高。

Abstract:

AIM: To investigate the effects and safety of intravitreal injection of Conbercept combined with macular grid pattern photocoagulation for macular edema secondary to non-ischemic branch retinal vein occlusion(BRVO).

METHODS: A total of 38 patients(38 eyes )with macular edema following non-ischemic BRVO were retrospectively analyzed. All patients were given best corrected visual acuity(BCVA), intraocular pressure, slit lamp with preset lens, optic coherent tomography(OCT)and fluorescence fundus angiography(FFA)examination. The BCVA and central macular thickness(CMT)were observed before and 1wk, 1, 2, 3, 6, 9 and 12mo after treatment. The change in pre-treatment and post-treatment were compared, and the related complications were recorded.

RESULTS:BCVA before treatment and 1wk, 1, 2, 3, 6, 9 and 12mo after treatment were 0.89±0.62, 0.64±0.59, 0.55±0.62, 0.46±0.43, 0.53±0.67, 0.43±0.38, 0.42±0.29, 0.40±0.30, the difference was statistically significant between that before and after treatment(P<0.001), while the BCVA after treatment showed no significant difference with each other(P>0.05). CMT were 683.25±236.47, 298.65±116.12, 276.89±107.28, 281.55±99.62, 251.41±119.47, 240.58±88.62, 231.74±75.36, 209.51±84.68μm, the difference was statistically significant between that before and after treatment(P<0.001), while the those after treatment showed no significant difference with each other(P>0.05). There were 11 eyes received one injection, 18 eyes with two injections, 2 eyes with 3, 3 eyes with 4, and 4 eyes more than 4, the average injection was 2.01±1.42. The CMT decreased after every injection. The intraocular hypertension and other complications were not seen after treatment.

CONCLUSION: Intravitreal injection of conbercept combined with macular grid pattern photocoagulation for macular edema to non-ischemic BRVO can reduce the macular edema and improve BCVA, which is effective and safety.