[关键词]
[摘要]
目的:探讨分析玻璃体腔注射康柏西普后短期眼压(IOP)升高的影响因素。
方法:临床前瞻性观察研究。共纳入玻璃体腔注射康柏西普的视网膜病变患者269例269眼,所有患眼均行康柏西普玻璃体腔注射治疗。其中,男143例,女126例; 年龄相关性黄斑变性(ARMD)患者201例,其他类型视网膜变性患者68例。平均年龄62.86±11.74岁,采用非接触气动式眼压计,分别在注射前,注射后10、30min,2和4h对患者进行IOP测量。根据注射后10min IOP升高情况来进行分组,IOP升高10 mmHg及以上定义为IOP升高组,IOP升高小于10 mmHg定义为IOP稳定组。采用多因素Logistic回归分析分析两组之间的差异。
结果:患者在注射后10、30min,2和4h的平均IOP分别为24.1、20.2、19.5、16.9 mmHg,注射后各个时间点的IOP较注射前平均升高6.7、3.1、1.7、0.5 mmHg。其中,IOP高组56例,IOP稳定组213例。两组患者年龄、最佳矫正视力(BCVA)、性别、眼别、疾病类型比较均无统计学差异(均P>0.05); 注药次数(Z=-4.389,P=0.012)、注射前IOP及注射后各时间点的IOP(t=-5.343,-10.467,-8.933,-6.124,-4.635,均P<0.01)比较差异均有统计学差异。多变量Logistic回归分析显示,基础IOP与注射后10min IOP升高呈正相关(B=-0.913,OR=0.521,95%CI:0.211~0.694,P=0.011)。
结论:基线IOP水平越高,注射后IOP升高的风险越高。基线IOP是影响玻璃体腔注射康柏西普后患眼短期IOP升高的主要相关因素,而注射次数可能是另一个风险因素。
[Key word]
[Abstract]
AIM:To investigate the factors associated with short-term elevation of intraocular pressure(IOP)after conbercept intravitreal injection.
METHODS:This study was a clinical prospective observational study. It enrolled in 269 eyes of 269 patients who were diagnosed retinopathy, and all patients receive conbercept intravitreal injection. Among them, 143 were males and 126 were females. There were 201 cases of age-related macular degeneration(ARMD)and 68 cases of other retinopathy patients. The mean age was 62.86±11.74 years. Non-contact pneumatic tonometer was used to measure the IOP of the patients before, 10, 30min, 2 and 4h after injection. The group was divided according to the IOP elevation 10min after injection. The IOP elevation 10 mmHg and above was defined as the IOP elevation group, and the IOP elevation less than 10 mmHg was defined as the IOP stable group. Multivariate Logistic regression analysis was used to analyze the differences between the two groups.
RESULTS:The average IOP of patients at 10, 30min, 2 and 4h after injection was 24.1, 20.2, 19.5 and 16.9 mmHg, respectively. The average IOP at each time point after injection was 6.7, 3.1, 1.7 and 0.5 mmHg higher than that before injection. Among them, 56 cases of increased IOP, 213 cases of stable IOP. There were no significant differences in age, best corrected visual acuity(BCVA), gender, eye side and disease type between two groups(all P>0.05). There were statistically significant differences in the number of injection(Z=-4.389, P=0.012), IOP before injection and IOP at each time point after injection(t=-5.343, -10.467, -8.933, -6.124, -4.635, all P<0.01). Multivariate Logistic regression analysis showed that baseline IOP was positively correlated with IOP increase 10min after injection(B=-0.913, OR=0.521, 95%CI: 0.211-0.694, P=0.011).
CONCLUSION: The higher the baseline IOP, the higher risk of elevated IOP after injection. The factor associated with a short-term increase in IOP after intravitreal injection of conbercept was baseline IOP. The number of injection may be another risk factor.
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[基金项目]
安徽省教育厅自然科学研究重点项目(No.KJ2019A1097); 安徽省卫健委科研计划项目(No.2018SEYL025)