玻璃体腔注射康柏西普治疗不同类型视网膜静脉阻塞伴黄斑水肿的疗效

Clinical therapeutic effects of intravitreal injection of Conbercept for macular edema in different types of retinal vein occlusion

摘要:

目的：观察玻璃体腔内注射康柏西普治疗不同类型视网膜静脉阻塞(RVO)伴黄斑水肿的临床疗效。

方法：回顾性研究。纳入79例79眼不同类型视网膜静脉阻塞伴黄斑水肿患者[视网膜分支静脉阻塞(BRVO)54眼，非缺血型视网膜中央静脉阻塞(non-iCRVO)16眼，缺血型视网膜中央静脉阻塞(iCRVO)9眼]，采用3+PRN方案治疗，随访6mo，记录基线、治疗后1d，1、2、3、4、5、6mo的最佳矫正视力(BCVA，LogMAR)、黄斑中心凹视网膜厚度(CMT)等变化。

结果：三种不同类型RVO治疗后6mo BCVA均较基线提高(0.22±0.23 vs 0.70±0.32； 0.24±0.19 vs 0.73±0.27； 1.20±0.37 vs 1.92±0.23； 均P<0.05)，OCT显示黄斑CMT明显降低(199±27 vs 422±162μm； 195±16 vs 550±158μm； 231±55 vs 583±152μm； 均P<0.05)。三种不同类型RVO在不同就诊时间组内治疗后各时间CMT均较基线下降(P<0.05)，不同就诊时间组间CMT均无差异(P>0.05)。BRVO、non-iCRVO患者在不同就诊时间组内治疗后BCVA均较基线改善(P<0.05)，iCRVO患者>90d组视力几乎无提升。

结论：玻璃体腔内注射康柏西普可以有效治疗RVO引起的黄斑水肿。对于RVO患者，早期及时的进行抗血管内皮生长因子(VEGF)治疗，有助于其远期视力的提高并维持稳定； 延迟抗VEGF药物治疗可能会降低其视力提升的空间。

Abstract:

AIM: To observe the therapeutic efficacy of intravitreal injection of conbercept for macular edema in different types of retinal vein occlusion(RVO).

METHODS: Retrospective cohort study of 79 patients 79 eyes in different types of RVO(BRVO:54; non-ischemic CRVO: 16; ischemic CRVO: 9)received intravitreal injection of conbercept. After 3mo injection of conbercept(IVIC), a pro re nata(PRN)strategy was adopted. The best-corrected visual acuity(BCVA,LogMAR)and central macular thickness(CMT)were recorded at baseline and at 1d, 1, 2, 3, 4, 5, 6mo post-treatment.

RESULTS: At 6mo, in different types of RVO, the BCVA were improved significantly than baseline(0.22±0.23 vs 0.70±0.32; 0.24±0.19 vs 0.73±0.27; 1.20±0.37 vs 1.92±0.23; all P<0.05). CMT were decreased significantly than baseline(199±27 vs 422±162μm; 195±16 vs 550±158μm; 231±55 vs 583±152μm; all P<0.05). In three different treatment time groups, CMT in different types of RVO were decresed than the baselineat different time points after treatment(P<0.05), and there was no difference between groups(P>0.05). In three different treatment time groups, BCVA in BRVO and non-iCRVO were improved than the baseline in three groups(P<0.05), but in iCRVO there were little improved in >90d group.

CONCLUSION: Intravitreal injection of conbercept can effectively treat macular edema caused by RVO. Early and timely treatment of anti-VEGF may help improve and maintain the stability of long-term vision, and delayed anti-VEGF treatment may reduce the space for the improving vision.