目的：评估在治疗-延长方案treat-and-extend(T&E)下玻璃体腔注射康柏西普治疗新生血管性年龄相关性黄斑变性(nAMD)的疗效。

方法：回顾性分析2020年5月至2022年5月随访2年的nAMD患者临床资料。所有患眼均先接受康柏西普玻璃体腔注射3次、每月1次的负荷治疗，随后根据病灶活动度进入T&E方案：病情稳定者每次延长注射间隔2或4周，最长延长至16周； 若病灶活动复发，则缩短注射间隔。根据既往治疗情况，将患者分为初治组和非初治组。比较24 mo随访期间两组患者最佳矫正视力(BCVA)、黄斑中心凹厚度(CMT)、注射次数及注射间隔等指标。

结果：共纳入27例患者(男15例，女12例，共33眼)。初治组18眼，平均年龄65.72±12.32岁。该组在治疗后1、3、6 mo BCVA较基线明显改善(P<0.05)，1、3 mo CMT较基线明显降低(P<0.05)。非初治组15眼，平均年龄69.00±9.21岁，该组在治疗后3 mo BCVA较基线显著改善(P<0.05)，而CMT变化无统计学差异(P>0.05)。两组基线CMT差异无统计学意义(P>0.05)，但在多个随访时间点CMT差异具有统计学意义(P<0.05)。两组总注射次数差异无统计学意义(P>0.05)。注射间隔方面，初治组以4 mo为主，非初治组以3-4 mo为主。

结论：在T&E方案下进行玻璃体腔注射康柏西普治疗，初治患者较非初治患者可获得更好的视功能和解剖学改善效果。

METHODS: A retrospective analysis was conducted on nAMD patients followed over a 2-year period(May 2020 to May 2022). All eyes received three monthly loading intravitreal injections of conbercept, followed by a T& E regimen in which the injection interval was extended by 2 or 4 wk according to disease activity, up to a maximum of 16 wk. When disease activity recurred, the interval was shortened. Patients were divided into initial and non-initial treatment groups based on treatment history. Best-corrected visual acuity(BCVA), central macular thickness(CMT), injection frequency, and intervals between injections over the 24-month follow-up were compared.

RESULTS:Totally 27 patients(15 males and 12 females, 33 eyes)were enrolled. In the initial treatment group(18 eyes, mean age 65.72±12.32 y), BCVA significantly improved at 1, 3, and 6 mo(P<0.05), and CMT significantly improved at 1 and 3 mo(P<0.05). In the non-initial treatment group(15 eyes, mean age 69.00±9.21 y), BCVA improved significantly at 3 mo(P<0.05), whereas CMT remained stable(P >0.05). Baseline CMT was similar between the groups(P>0.05). However, significant differences were observed at multiple post-injection time points(P<0.05). The total number of injections did not differ between the groups(P>0.05). Intervals between injections varied, with the majority at 4 and 3-4 mo in the initial and non-initial treatment groups, respectively.

CONCLUSION:Initiating intravitreal conbercept therapy under a T & E regimen results in superior visual and anatomical outcomes compared with non-initial treatment.