联合疗法治疗非缺血性视网膜中央静脉阻塞继发黄斑水肿的效果分析

Combined therapy to treat macular edema secondary to non-ischaemic central retinal vein occlusion

目的观察单次玻璃体腔注射康柏西普联合黄斑格栅光凝治疗非缺血性视网膜中央静脉阻塞(CRVO)继发黄斑水肿的临床疗效。方法非随机对照临床回顾性研究,65例(65只眼)经眼科常规检查以及荧光素眼底血管造影(FFA)和相干光断层扫描(OCT)检查确诊的非缺血性CRVO患者纳入研究。按治疗方法分两组:一组为康柏西普+激光组(CL组),一组为康柏西普组单纯注射组(C组),分别为31例(31只眼)、34例(34只眼)。CL组只注射康柏西普次数1次,随访时间(4.12±1.81)个月,C组注射次数1~3次,随访时间(3.98±2.02)月。比较术前、术后1、2、3个月两组间以及各组内部的最佳矫正视力(BCVA)和黄斑中心视网膜厚度(CMT)。结果CL组、C组视力提高率分别为51%、55%,差异无统计学意义(P>0.05);治疗前,CL组患者CMT为(638.31±174.23)um,C组患者CMT为(619.65±176.08)um,数据无统计学差异(P>0.05);两组间不同观察时间点平均CMT(F=14.157,16.426)比较,差异均有统计学意义(P<0.01),CL组治疗后不同观察时间点平均CMT与C组比较,差异无统计学意义(P>0.05)。随访中未见与注射及药物有关的眼部和全身不良反应。结论单次玻璃体腔注射康柏西普联合黄斑格栅光凝有效的促进黄斑水肿吸收,同时减少了玻璃体腔注射次数。

Objective To investigate the efficacy and safety of single intravitreal Conbercept combined with macu- lar laser grid photocoagulation for macular edema in non-ischemic central retinal vein occlusion （ CRVO）. Methods The comparative nonrandomized retrospective clinical interventional study included 65 eyes of 65 patients with non-ischemic CR- VO diagnosed according to fundus fluorescein angiography （FFA） and optical coherence tomography （ OCT）. Patients were assigned to 2 groups： intravitreal Conbercept combined with laser photocoagulation for 31 patients （31 eyes; CL group） , and intravitreal Conbercept alone for the other 34 patients （ 34 eyes ; C group ）. During follow-up, re-injections may be ad- ministered to patients in C group （total 1 -3 injections）. Patients in CL group had only 1 injection. Mean follow-up was 4. 12± 1.81 months in CL group and 3.98 ± 2. 02 months in C group. Best corrected visual acuity I BCVA）, OCT, and FFA were assessed before and at 1, 2, 3 months after treatment. Results Rate of vision improvement in CL group and C group were 51% and 55% respectively, indicating no significant difference （ P 〉 0. 05 ） between the 2 groups. Before treatment, CMT was 638.31± 174.23 m in CL group and 619.65± 176. 08 txm in C group, and there was no significant difference （ P 〉 0.05 ）. After treatment, CMT reduced significantly at all time-points （ 1,3, and 6 months） compared to pre-treatment CMT in both groups （ F = 14. 157, 16. 426）. However, there was no difference between the two groups at any given post-treatment time-point. No ocular or systemic adverse events were found during the follow-up period. Conclu- sions Single intravitreal injection of Conbercept combined with laser photocoagulation for macular edema in non-ischemic central retinal vein occlusion is as effective and safe as multiple injections without laser photocoagulation.