玻璃体腔注射抗VEGF药物对MCNV和ICNV治疗前后BCVA及mfERG的影响

Effect of intravitreal injection of anti VEGF drugs on BCVA and mfERG before and after treatment for MCNV and ICNV

目的:研究玻璃体腔注射抗VEGF药物对脉络膜新生血管疾病前后BCVA及mfERG变化影响。方法:选取2015-01/2017-01在本院接受治疗的病理性近视黄斑新生血管的病变(myopic choroid neovascularization,MCNV)和特发性的脉络膜新生血管病变(idiopathic choroidal neovascularization,ICNV)患者264例332眼。检测患者的眼压和最佳矫正视力(BCVA),眼底使用90D前置镜和裂隙灯联合检测,并对眼底进行摄片,行OCT检测,进行ICGA和FFA的造影检测,最后行mfERG检测。记录患者注药后1d,1mo和末次治疗后1mo的BCVA、眼压和mfERG等情况。结果:使用雷珠单抗注射254眼,康柏西普注射78眼,其中注射1次的有37眼,注射2次的有147眼,注射3次的有72眼,注射4次的有57眼,注射5次的有19眼;患者治疗前眼压和治疗后1mo、末次治疗后1mo对比差异无统计学意义(P>0.05),患者治疗前BVCA和治疗后1mo、末次治疗后1mo对比差异均有统计学意义(P<0.05);患者治疗后Ring1、Ring2和Ring4振幅的密度均有提高,差异有统计学意义(P<0.05),末次治疗后1moRing3和Ring5振幅的密度也有提高,差异有统计学意义(P<0.05)。结论:在玻璃体腔注射抗VEGF药物对脉络膜新生血管疾病患者BCVA和mfERG有明显改善作用,且比较安全。

AIM ： To study the effect of intravitreal injection of anti- vascular endothelial growth factor （VEGF） on best corrected visual acuity （ BCVA ） and multifocal - electroretinogram （mfERG） before and after treatment for choroidal neovascular disease. METHODS： A total of 264 patients （332 eyes） with macular neovascularization （ MCNV ） and idiopathic choroidal neovascular disease （ICNV） who underwent pathologic myopia from January 2015 to January 2017 were enrolled in this study. Intraocular pressure and BCVA, fundus using 90D front mirror and slit lamp detection, and the fundus photograph, OCT, ICGA and FFA angiography, mfERG detection were taken. One month after the drug, 1too after the final treatment, we recorded BCVA, intraocular pressure and mfERG and so on. RESULTS： Ranibizumab was injected into the 254 eyes, and 78 eyes were injected with conbercept. There were 37 eyes injected once, 147 eyes were injected twice, 72 eyes were injected 3 times, 57 eyes were injected 4 times, 19 eyes 5 times. There were no significant differences on intraocular pressure between the two groups （P〉 0. 05）. The BCVA before treatment was significantly different compared with those 1too after treatment and 1too after the final treatment （ P〉 0.05）. The amplitude of Ring1, Ring2 and Ring4 increased after treatment, the difference was statistically significant. （P〈0.05）. The amplitude of Ring3 and Ring5 increased at 1 mo after final treatment（P〈0.05）. CONCLUSION ：lntravitreal injection of anti-VEGF drugs has a significant effect on BCVA and mf ERG in patients with choroidal neovascular disease and is safe.