玻璃体腔注射康柏西普对不同OCT分型糖尿病黄斑水肿的疗效观察
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摘要
目的:观察玻璃体腔注射康柏西普对不同OCT分型糖尿病黄斑水肿(DME)的疗效差异。方法:DME患者96例96眼根据OCT形态特征将DME分为弥漫性黄斑水肿(DRT,35眼)、囊性黄斑水肿(CME,33眼)、浆液性视网膜脱离(SRD,28眼),所有患者行玻璃体腔注射0.5mg(0.05mL)康柏西普治疗。治疗后1、3、6mo,比较三组BCVA(LogMAR)、黄斑中心凹视网膜厚度(CFT)、注射次数及视力提高眼数的差异。结果:随访6mo,三组患眼BCVA呈明显下降趋势(F_(时间)=205.880,P_(时间)<0.01),三组间比较有差异(F_(组间)=3.472,P_(组间)=0.042),其中DRT组治疗后BCVA改善最佳;三组患眼CFT呈明显降低趋势(F_(时间)=392.994,P_(时间)<0.01),三组间比较有差异(F_(组间)=5.046,P_(组间)=0.012),DRT组和CME组的CFT降低程度优于SRD组。随访6mo DRT组的注射次数最少,视力提高眼数比例最高。结论:玻璃体腔注射康柏西普可显著改善不同OCT分型DME患眼的视力,降低CFT,其中DRT疗效最佳,注射次数最少。
AIM: To observe the efficacy of intravitreal injection of conbercept for diabetic macular edema(DME) with different patterns of optical coherence tomography(OCT).METHODS: A total of 96 patients(96 eyes) with DME were classified as diffuse retinal thickening(DRT group, 35 eyes), cystoid macular edema(CME group, 33 eyes) and serous retinal detachment(SRD group, 28 eyes) according to the OCT.All patients were treated with intravitreal injection of 0.5 mg(0.05 mL) conbercept.The changes of best corrected visual acuity(BCVA), central foveal thickness(CFT), the injection times and vision improves eyes were compared between three groups after 1,3,6mo treatment.RESULTS: After 6mo follow up, the BCVA of the three groups showed a significant downward trend(F_(time)=205.880, P_(time)<0.01), and there were significant differences among the three groups(F_(group)=3.472, P_(group)=0.042).The DRT group had the best BCVA after treatment.The CFT of the three groups showed a significant downward trend(F_(time)=392.994, P_(time)<0.01), and there were significant differences among the three groups(F_(group)=5.046, P_(group)=0.012).The reduction of CFT in the DRT group and CME group were better than that in the SRD group.The DRT group had the least injection times, and the highest proportion of vision improves eyes after 6mo follow up.CONCLUSION: The intravitreal injection of conbercept could significantly improve the visual acuity and reduce the CFT of DME with different OCT patterns.And DRT is themost effective type with the least injection times.
AIM: To observe the efficacy of intravitreal injection of conbercept for diabetic macular edema(DME) with different patterns of optical coherence tomography(OCT).METHODS: A total of 96 patients(96 eyes) with DME were classified as diffuse retinal thickening(DRT group, 35 eyes), cystoid macular edema(CME group, 33 eyes) and serous retinal detachment(SRD group, 28 eyes) according to the OCT.All patients were treated with intravitreal injection of 0.5 mg(0.05 mL) conbercept.The changes of best corrected visual acuity(BCVA), central foveal thickness(CFT), the injection times and vision improves eyes were compared between three groups after 1,3,6mo treatment.RESULTS: After 6mo follow up, the BCVA of the three groups showed a significant downward trend(F_(time)=205.880, P_(time)<0.01), and there were significant differences among the three groups(F_(group)=3.472, P_(group)=0.042).The DRT group had the best BCVA after treatment.The CFT of the three groups showed a significant downward trend(F_(time)=392.994, P_(time)<0.01), and there were significant differences among the three groups(F_(group)=5.046, P_(group)=0.012).The reduction of CFT in the DRT group and CME group were better than that in the SRD group.The DRT group had the least injection times, and the highest proportion of vision improves eyes after 6mo follow up.CONCLUSION: The intravitreal injection of conbercept could significantly improve the visual acuity and reduce the CFT of DME with different OCT patterns.And DRT is themost effective type with the least injection times.
引文
1 Ansari WH,Han MM,Haq S,et al.Baseline Ocular Characteristics of Patients Undergoing Initiation of Anti-Vascular Endothelial Growth Factor Therapy for Diabetic Macular Edema.Ophthalmic Surg Lasers Imaging Retina 2019;50(2):69-75
2孙清磊,闫焱,祝丽娜,等.康柏西普对糖尿病性黄斑水肿的疗效评价.上海交通大学学报(医学版)2017;37(5):652-655
3 Li F,Zhang L,Wang Y,et al.One-Year Outcome of Conbercept Therapy for Diabetic Macular Edema.Curr Eye Res 2018;43(2):218-223
4 Erol N,Gursoy H,Kimyon S,et al.Vision,retinal thickness,and foveal avascular zone size after intravitreal bevacizumab for diabetic macular edema.Adv Ther 2012;29(4):359-369
5许迅,卢一.重视对糖尿病黄斑水肿的诊治.中华眼底病杂志2018;34(4):313-316
6 Kwon JW,Jee D.Correction:Aqueous humor cytokine levels in patients with diabetic macular edema refractory to anti-VEGF treatment.PLoS One 2018;13(11):e0207902
7 Brito P,Costa J,Gomes N,et al.Serological inflammatory factors as biomarkers for anatomic response in diabetic macular edema treated with anti-VEGF.J Diabetes Complications 2018;32(7):643-649
8金辉,夏蔚.康柏西普治疗脉络膜新生血管的临床研究.中国临床药理学杂志2018;34(21):2513-2515
9张召弟,郭晟,帅天姣,等.玻璃体内注射康柏西普对弥漫性糖尿病性黄斑水肿的影响.眼科新进展2018;38(1):69-72
10 Cai S,Yang Q,Li X,et al.The efficacy and safety of aflibercept and conbercept in diabetic macular edema.Drug Des Devel Ther 2018;12:3471-3483
11 Sheu SJ,Lee YY,Horng YH,et al.Characteristics of diabetic macular edema on optical coherence tomography may change over time or after treatment.Clin Ophthalmol 2018;12:1887-1893
12 Chan GCY,Kamble R,Muller H,et al.Fusing Results of Several Deep Learning Architectures for Automatic Classification of Normal and Diabetic Macular Edema in Optical Coherence Tomography.Conf Proc IEEE Eng Med Biol Soc 2018;2018:670-673
13 Moisseiev E,Abbassi S,Thinda S,et al.Subthreshold micropulse laser reduces anti-VEGF injection burden in patients with diabetic macular edema.Eur J Ophthalmol 2018;28(1):68-73
14王韫智,郑志.光相干断层扫描联合微视野检查在糖尿病黄斑水肿中的应用研究进展.中华眼底病杂志2018;34(4):404-407
2孙清磊,闫焱,祝丽娜,等.康柏西普对糖尿病性黄斑水肿的疗效评价.上海交通大学学报(医学版)2017;37(5):652-655
3 Li F,Zhang L,Wang Y,et al.One-Year Outcome of Conbercept Therapy for Diabetic Macular Edema.Curr Eye Res 2018;43(2):218-223
4 Erol N,Gursoy H,Kimyon S,et al.Vision,retinal thickness,and foveal avascular zone size after intravitreal bevacizumab for diabetic macular edema.Adv Ther 2012;29(4):359-369
5许迅,卢一.重视对糖尿病黄斑水肿的诊治.中华眼底病杂志2018;34(4):313-316
6 Kwon JW,Jee D.Correction:Aqueous humor cytokine levels in patients with diabetic macular edema refractory to anti-VEGF treatment.PLoS One 2018;13(11):e0207902
7 Brito P,Costa J,Gomes N,et al.Serological inflammatory factors as biomarkers for anatomic response in diabetic macular edema treated with anti-VEGF.J Diabetes Complications 2018;32(7):643-649
8金辉,夏蔚.康柏西普治疗脉络膜新生血管的临床研究.中国临床药理学杂志2018;34(21):2513-2515
9张召弟,郭晟,帅天姣,等.玻璃体内注射康柏西普对弥漫性糖尿病性黄斑水肿的影响.眼科新进展2018;38(1):69-72
10 Cai S,Yang Q,Li X,et al.The efficacy and safety of aflibercept and conbercept in diabetic macular edema.Drug Des Devel Ther 2018;12:3471-3483
11 Sheu SJ,Lee YY,Horng YH,et al.Characteristics of diabetic macular edema on optical coherence tomography may change over time or after treatment.Clin Ophthalmol 2018;12:1887-1893
12 Chan GCY,Kamble R,Muller H,et al.Fusing Results of Several Deep Learning Architectures for Automatic Classification of Normal and Diabetic Macular Edema in Optical Coherence Tomography.Conf Proc IEEE Eng Med Biol Soc 2018;2018:670-673
13 Moisseiev E,Abbassi S,Thinda S,et al.Subthreshold micropulse laser reduces anti-VEGF injection burden in patients with diabetic macular edema.Eur J Ophthalmol 2018;28(1):68-73
14王韫智,郑志.光相干断层扫描联合微视野检查在糖尿病黄斑水肿中的应用研究进展.中华眼底病杂志2018;34(4):404-407