目的：观察玻璃体内注射康柏西普(IVC)治疗糖尿病性新生血管性青光眼(NVG)的疗效。

方法：回顾性研究。收集我院自2019年1月至2022年12月收治的增殖性糖尿病视网膜病变(PDR)合并NVG(II期)患者57例57眼的临床资料，根据治疗方法不同分为观察组30例30眼行IVC联合全视网膜光凝治疗(PRP)，对照组27例27眼行单纯PRP治疗，随访2 a。比较两组患者治疗前后最佳矫正视力(BCVA，LogMAR)、眼压、房角新生血管(NVA)、黄斑中心凹厚度(CMT)变化及病程进展情况。

结果：治疗前两组患者一般资料比较无差异(P>0.05)。末次随访时观察组BCVA优于对照组(P<0.05)，观察组眼压、CMT及NVA进展均低于对照组(均P<0.05)，NVG由Ⅱ期进展至Ⅲ期患者观察组少于对照组(P<0.05)。观察组治疗后6 mo BCVA较治疗前提高(P<0.05)； 对照组治疗后24 mo BCVA较治疗前下降(P<0.05)； 采用多重线性回归分析提示NVG进展和眼压是影响BCVA(LogMAR)变化的因素(β=0.511，0.014，t=4.461，2.092，P<0.01，0.041)。观察组治疗后1、6、12 mo眼压较治疗前降低(均P<0.05)，治疗后18、24 mo较治疗前比较无差异(均P>0.05)； 对照组治疗后6 mo眼压较治疗前降低(P<0.05)，治疗后1、12、18、24 mo较治疗前比较均无差异(均P>0.05)。观察组及对照组各随访点使用药物种类分析均无差异(均P>0.05)。两组治疗期间无感染性眼内炎及其他意外风险发生。

结论：IVC联合PRP治疗PDR合并Ⅱ期NVG患者，在控制虹膜新生血管、减缓视力损伤、降眼压及延缓疾病进展方面优于单纯PRP治疗。

METHODS:Retrospective study. Totally 57 patients(57 eyes)with NVG(stage II)secondary to proliferative diabetic retinopathy(PDR)treated in our hospital were collceted from January 2019 to December 2022. Among them, 30 patients(30 eyes)were treated by IVC and panretinal photocoagulation(PRP)in the observation group, and 27 patients(27 eyes)were treated by PRP in the control group. The best corrected visual acuity(BCVA, LogMAR), intraocular pressure, neovascularization of the iridocorneal angle(NVA), central macular thinkness(CMT)changes and disease progression were analyzed with a follow-up of 2 years.

RESULTS: There were no significant differences in baseline characteristics between the two groups(P>0.05). At the last follow-up, the BCVA in the observation group was better than the control group(P<0.05). The intraocular pressure, CMT and progression of NVA in the observation group were less than the control group(all P<0.05). The patients with NVG developed from stage II to stage III in the observation group was less than the control group(P<0.05). In the observation group, the BCVA improved compared with preoperative at 6 mo(P<0.05). In the control group, the BCVA decreased compared with preoperative after 24 mo(P<0.05). Multiple linear regression analysis indicated that NVG progression and intraocular pressure were factors affecting BCVA(LogMAR)changes(β=0.511, 0.014; t=4.461, 2.092; P<0.01, 0.041, respectively). In the observation group, the IOP decreased at 1, 6 and 12 mo compared with preoperative(all P<0.05), while there were no significant differences at 18 and 24 mo compared with preoperative(all P>0.05). In the control group, the intraocular pressure decreased at 6 mo compared with preoperative(P<0.05), while there were no significant differences at 1, 12, 18 and 24 mo compared with preoperative(all P>0.05). There were no significant difference about the types of glaucoma drugs between the observation group and the control group(all P>0.05). There were no infectious endophthalmitis and other complications observed in both groups.

CONCLUSION: IVC combined with PRP demonstrates superior efficacy over PRP monotherapy in treating NVG(stage II)secondary to PDR. IVC combined with PRP showed better outcomes in controlling iris neovascularization, slowing visual impairment progression, reducing intraocular pressure, and delaying disease advancement.