玻璃体腔注射Conbercept联合视网膜光凝治疗糖尿病黄斑水肿的疗效研究

Efficacy and frequency of intravitreal injection of conbercept combined with retinal laser photocoagulation for diabetic macular edema

目的探讨玻璃体腔注射抗血管内皮生长因子（VEGF）药物康柏西普（Conbercept）联合视网膜光凝与单纯玻璃体腔注射Conbercept治疗糖尿病黄斑水肿（DME）的疗效分析。方法前瞻性临床病例对照研究。对2014年11月至2015年10月在北京京煤集团总医院眼科就诊的48例（50只眼）糖尿病黄斑水肿患者随机分为玻璃体腔注射Conbercept联合视网膜光凝治疗组和单纯注药组，对比治疗后1个月和6个月的最佳矫正视力（BCVA）和黄斑厚度（CMT）变化结果及注药次数进行统计学分析。结果两组治疗后1个月BCVA，分别提高（8．26±17．32）与（8．05±18．48）字符，治疗后第6个月BCVA，分别提高（10．41±15．95）与（9．37±19．49）字符，治疗后1个月CMT分别降低为（228．26±135．32）和（219．05±142．45）μm，治疗后6个月CMT分别降低为（230．41±145．62）和（226．37±139．63）μm，变化差异无统计学意义（P〉0．05）；两组治疗后第1个月和治疗后第6个月BCVA均比治疗前提高，CMT均比治疗前明显下降，差异有统计学意义（P〈0．05）。6个月内为保持BCVA的提高和CMT的稳定，单纯组需要更多注药次数。结论玻璃体腔注射Conbercept联合视网膜光凝治疗与单纯玻璃体腔注射Conbercept对糖尿病黄斑水肿均有较好疗效，联合激光治疗可以在一定时间内减少玻璃体腔注药次数。

Objective To investigate the effects and cost of intravitreal injection of conbercept and retinal photocoagulation for diabetic macular edema. Methods This prospective case series comprised of 48 patients （50 eyes） with diabetic macular edema at Beijing Jingmei Group General Hospital. All patients were randomly divided into intravitreal injection of conbercept （IVC） group,focal/grid/ pan retinal laser photocoagulation combined with intravitreal injection of conbercept （combine） group. The best corrected visual acuity （BCVA）, slit-lamp, intraocular pressure, optical coherence tomography, fundus examination were performed at pre-operation and postoperative 1 months, 6 months. Results The BCVA were improved in both groups in postoperative 1 month （8.26±17.32 and 8.05± 18.48 ETDRS letter） and in postoperative 6 months （10.41±15.95） and （9.37±19.49）ETDRS letter （P 〈 0.05）. The macular thickness （CMT） were reduced in both groups in postoperative 1 month （228.26± 135.32） and （219.05±142.45）μm and in postoperative 6 months （230.41±145.62） and （226.37±139.63） μm （P 〈0.05）. No significant difference was found between IVC group and combine group for BCVA and CMT （P 〉0.05）. However, during 6 months, in order to stabilize the improvement of BCVA and CMT, compared with group B, obvious more repeated injection time were needed in IVC group. Conclusions Intravitreal injection of conbercept with or without retinal laser photocoagulationremarkably ameliorate the macular edema and improve the visual acuity in the short-term, intravitreal injection of conbercept with retinal laser photocoagulation is more costless to treat diabetic macular edema.