玻璃体腔内注射康柏西普治疗糖尿病视网膜病变合并视网膜静脉阻塞性黄斑水肿的效果观察
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摘要
目的 观察玻璃体腔内注射康柏西普治疗糖尿病视网膜病变合并视网膜静脉阻塞性黄斑囊样水肿的疗效。方法 回顾性分析2016年1月至2018年2月确诊为糖尿病视网膜病变合并视网膜静脉阻塞,且黄斑囊样水肿的患者65例,66只眼,分为2组。一组行患眼球后注射曲安奈德20 mg,33例,33眼,另一组行玻璃体腔内注射康柏西普0.05 ml,32例,33眼。观察治疗前及治疗后1 d、1周、2周、4周的最佳矫正视力和黄斑中心凹厚度的改变。结果 所有患者治疗后均无明显并发症发生。与治疗前比较,曲安奈德治疗组仅在治疗后1周和2周时最佳矫正视力较治疗前提高、黄斑中心凹厚度下降,差异有统计学意义(P<0.05),余时间点均差异无统计学意义(P>0.05);康柏西普治疗组在治疗后1 d、1周、2周、4周时最佳矫正视力提高、黄斑中心凹厚度也下降,差异有统计学意义(P<0.05)。结论 玻璃体腔内注射康柏西普治疗糖尿病视网膜病变合并视网膜静脉阻塞性黄斑水肿安全性高,起效时间短,降低黄斑区视网膜厚度明显。
Objective To observe the therapeutic effects of intravitreal injection of Conbercept on diabetic retinopathy(DR) complicated by retinal vein occlusion(RVO) and cystoid macular edema(CME).Methods The clinical dat about 65 patients(66 eyes) with diabetic retinopathy complicated by RVO and CME were diagnosed and treated in our hospital from January 2016 to February 2018 were retrospectively analyzed,who were divided into froup A and group B.The 33 patients in group A(33 eyes) were treated by retrobulbar injection with triamcinolone acetonide(TA) 20 mg,and the other 32 patients(33 eyes) in group B were treated by intravitreal injection with Conbercept 0.05 ml.The best corrected visual acuity(BCVA) and central foveal thickness(CFT) before and at 1 day,1 w, 2 w,4 w after treatment were observed and compared between the two groups.Results No significant complications were observed in all the patients after treatment. As compared with that before treatment, BCVA was significantly increased and CFT was significantly decreased at 1 w and 2 w after treatment in group A(P<0.05)and there was no significant difference in the other time points(P>0.05).Moreover the BCVA in group B was significantly increased and CFT was significantly decreased at 1 day, 1 w, 2 w, 4 w after treatment(P<0.05). In addition the therapeutic effects in group A were superior to those in group B.Conclusion Intravitreal injection of Conbercept to treat DR complicated by RVO and CME has higher safety and short onset time, which can reduce macular retinal thickness obviously.
Objective To observe the therapeutic effects of intravitreal injection of Conbercept on diabetic retinopathy(DR) complicated by retinal vein occlusion(RVO) and cystoid macular edema(CME).Methods The clinical dat about 65 patients(66 eyes) with diabetic retinopathy complicated by RVO and CME were diagnosed and treated in our hospital from January 2016 to February 2018 were retrospectively analyzed,who were divided into froup A and group B.The 33 patients in group A(33 eyes) were treated by retrobulbar injection with triamcinolone acetonide(TA) 20 mg,and the other 32 patients(33 eyes) in group B were treated by intravitreal injection with Conbercept 0.05 ml.The best corrected visual acuity(BCVA) and central foveal thickness(CFT) before and at 1 day,1 w, 2 w,4 w after treatment were observed and compared between the two groups.Results No significant complications were observed in all the patients after treatment. As compared with that before treatment, BCVA was significantly increased and CFT was significantly decreased at 1 w and 2 w after treatment in group A(P<0.05)and there was no significant difference in the other time points(P>0.05).Moreover the BCVA in group B was significantly increased and CFT was significantly decreased at 1 day, 1 w, 2 w, 4 w after treatment(P<0.05). In addition the therapeutic effects in group A were superior to those in group B.Conclusion Intravitreal injection of Conbercept to treat DR complicated by RVO and CME has higher safety and short onset time, which can reduce macular retinal thickness obviously.
引文
1 刘新.糖尿病视网膜病变合并视网膜静脉阻塞的眼底改变及荧光素血管造影分析.临床眼科杂志2009,17:448-449.
2 Agarwal A,Afridi R,Hassan M.Novel therapies in development for diabetic macular edema.Curr Diab Rep,2015,15:74-86.
3 廖菊生.糖尿病视网膜病变与视网膜静脉阻塞的异同.中华眼底病杂志,2001,17:89.
4 万敏婕,杨先凤.SD-OCT及FFA在白内障术后黄斑囊样水肿研究中的应用.眼科新进展,2015,35:55-59.
5 Chart CK,Jain A,Sadda S,et al.Optical coherence tomographic and visual results at six months after transitioning to aflibercept for patients on prior ranibizumab or bevacizumab treatment for exudafive age—related macular degeneration(an American Ophthalmological Society Thesis)Tram Am Ophthalmol Soc,2014,112:160-198.
6 Cohen SY,Nghiem-Buffet S,Grenet T,et al.Long-term variable outcome of myopic choroidal neovascularization treated with ranibizumab.J Ophlllalmol,2015,59:36-42.
7 路航,崔璟琳,董辉,等.康柏西普治疗湿性年龄相关性黄斑变性的临床疗效观察.中华眼科杂志,2015,51:818-821.
8 陈子畅,袁进萍,樊芯.雷珠单抗与康柏西普玻璃体腔注射治疗糖尿病黄斑水肿的效果对比.宁夏医学杂志,2016,38:1147-1149.
9 Comyn O,Sivaprasad S,Peto T,et al.A randomized trial to assess functional and structural effects of ranibizumab versus laser in diabeticmacular edema.Am J Ophthalmol,2014,157:960-970.
10 李恒健,魏莉,吕绍成.康柏西普治疗视网膜中央静脉阻塞的临床观察.临床眼科杂志,2017,25:70-71.
11 祁媛媛,祝莹,徐少凯,等.玻璃体内注射康柏西普治疗Irvine-Gass综合征.中华眼外伤职业病杂志,2018,40:59-62.
12 余敏,张然,赵媛.青光眼引流器植入联合康柏西普治疗新生血管性青光眼.中华眼外伤职业病杂志,2016,38:502-505.
13 修立恒,李佳林,李常栋,等.玻璃体内注射雷珠单抗治疗病理性近视合并脉络膜新生血管疗效观察.眼科新进展,2015,35:1067-1070.
14 Li X,Xu G,Wang Y,et al.Safety and efficacy of conbercept in neovascular age-related macular degeneration:results from a 12-month randomized phase 2 study:AURORA study.Ophthalmology,2014,121:1740-1747.
15 Du L,Peng H,Wu Q,et al.Observation of total VEGF level in hyperglycemic mouse eyes after intravitreal injection of the novel anti-VEGF drug conbercept.Mol Vis,2015,21:185-193.
2 Agarwal A,Afridi R,Hassan M.Novel therapies in development for diabetic macular edema.Curr Diab Rep,2015,15:74-86.
3 廖菊生.糖尿病视网膜病变与视网膜静脉阻塞的异同.中华眼底病杂志,2001,17:89.
4 万敏婕,杨先凤.SD-OCT及FFA在白内障术后黄斑囊样水肿研究中的应用.眼科新进展,2015,35:55-59.
5 Chart CK,Jain A,Sadda S,et al.Optical coherence tomographic and visual results at six months after transitioning to aflibercept for patients on prior ranibizumab or bevacizumab treatment for exudafive age—related macular degeneration(an American Ophthalmological Society Thesis)Tram Am Ophthalmol Soc,2014,112:160-198.
6 Cohen SY,Nghiem-Buffet S,Grenet T,et al.Long-term variable outcome of myopic choroidal neovascularization treated with ranibizumab.J Ophlllalmol,2015,59:36-42.
7 路航,崔璟琳,董辉,等.康柏西普治疗湿性年龄相关性黄斑变性的临床疗效观察.中华眼科杂志,2015,51:818-821.
8 陈子畅,袁进萍,樊芯.雷珠单抗与康柏西普玻璃体腔注射治疗糖尿病黄斑水肿的效果对比.宁夏医学杂志,2016,38:1147-1149.
9 Comyn O,Sivaprasad S,Peto T,et al.A randomized trial to assess functional and structural effects of ranibizumab versus laser in diabeticmacular edema.Am J Ophthalmol,2014,157:960-970.
10 李恒健,魏莉,吕绍成.康柏西普治疗视网膜中央静脉阻塞的临床观察.临床眼科杂志,2017,25:70-71.
11 祁媛媛,祝莹,徐少凯,等.玻璃体内注射康柏西普治疗Irvine-Gass综合征.中华眼外伤职业病杂志,2018,40:59-62.
12 余敏,张然,赵媛.青光眼引流器植入联合康柏西普治疗新生血管性青光眼.中华眼外伤职业病杂志,2016,38:502-505.
13 修立恒,李佳林,李常栋,等.玻璃体内注射雷珠单抗治疗病理性近视合并脉络膜新生血管疗效观察.眼科新进展,2015,35:1067-1070.
14 Li X,Xu G,Wang Y,et al.Safety and efficacy of conbercept in neovascular age-related macular degeneration:results from a 12-month randomized phase 2 study:AURORA study.Ophthalmology,2014,121:1740-1747.
15 Du L,Peng H,Wu Q,et al.Observation of total VEGF level in hyperglycemic mouse eyes after intravitreal injection of the novel anti-VEGF drug conbercept.Mol Vis,2015,21:185-193.