眼内注射KH902联合黄斑格栅样光凝治疗糖尿病性黄斑水肿

Intravitreal KH902 plus macular grid laser photocoagulation for diabetic macular edema

目的评价玻璃体腔内注射KH902联合黄斑格栅样光凝治疗糖尿病黄斑水肿的临床意义。方法将临床确诊为糖尿病弥漫性黄斑水肿的患者58例随机分为两组,单纯玻璃体腔注药组(28眼)接受玻璃体腔内注射KH902治疗,联合治疗组(30眼)接受玻璃体腔内注射KH902联合黄斑格栅样光凝治疗。观察6个月随访期内两组患者的最佳矫正视力、黄斑中心凹视网膜厚度、平均注药次数和间隔时间。结果联合治疗组的平均注射次数少于单纯注药组(P<0.05);联合治疗组的重复注射间隔时间比单纯注药组明显延长(P<0.05);随访结束时两组患者的黄斑中心凹厚度均比治疗前降低(P<0.05);而最佳矫正视力两组差异无统计学意义(P>0.05)。结论玻璃体腔内注药联合黄斑格栅样光凝可以明显延长糖尿病黄斑水肿复发的时间,通过减少注射次数而降低治疗成本。

【Objective】To evaluate the clinical efficacy of intravitreal injection of KH902 combined with macular grid photocoagulation for diabetic macular edema（DME）.【Methods】Totally 58 eyes（58 patients） with diffuse diabetic macular edema（DDME） were randomly divided into 2 groups： 28 eyes of simple injection group underwent intravitreal injection of KH902, and 30 eyes of combined group underwent an additional macular grid photocoagulation after the initial intravitreal injection of KH902. The best corrected visual acuity（BCVA）, central macular thickness（CMT） measured by optical coherence tomography（OCT）, the mean number of injections and the mean duration between the injections were observed. All the patients were followed-up monthly for 6 months after the initial intravitreal injection. 【Results】By the end of the follow-up period, the mean number of injections was significantly lower（P 0.05） in the combined group than in the simple injection group. The mean duration between the injections was significantly longer in the combined group than in the simple injection group（P 0.05）. In each group, the difference between the mean CMT at the baseline and at the end of the follow-up period was statistically significant（P 0.05）. The difference in the mean BCVA between the baseline and the end of the follow-up period was not statistically significant in either group（P 0.05）.【Conclusions】Macular grid photocoagulation following initial intravitreal injection of KH902 might provide a longer disease-free interval and reduce the burden of more frequent injections.