摘要
AIM: To appraise the effect of treatment for diabetic macular edema(DME) in proliferative stage with sufficient panrentinal photocoagulation(PRP) therapy and intravitreal injections(IV) Conbercept and posterior subtenon's triamcinolone acetonide(STTA) sequential therapy.METHODS: This prospective clinical randomized controlled trial of cross-over design was conducted in three phases. The participants included cases of DME in proliferative stage. They were divided into two groups and treated with PRP before enrollment. Group A were treated with IVConbercept 0.5 mg for one month in the 1^st phase. Group B were treated with STTA 40 mg(twice per two weeks). The interventions were exchanged in the second phase(2mo) between the two groups. In the third phase(3-6mo) no other treatment was given. Best corrected visual acuity(BCVA), central macular thickness(CMT) measured by OCT and complications were compared.RESULTS: After phase I: in Group A, BCVA improved from 0.201±0.17 to 0.37±0.24(F=5.88, P=0.004). CMT changed from 449±155.10 to 304.1±84.70 μm(F=14.9, P〈0.01). In Group B, BCVA changed from 0.195±0.19 to 0.26±0.20(F=0.76, P=0.41) while CMT changed from 463.82±152.92 to 366.00±115.40 μm(F=3.70, P〈0.03). The improvement of BCVA was better in Group A(P〈0.05). After phase II: in Group A, BCVA raised to 0.47±0.27(F=0.26, P〈0.01), CMT reduced to 260.67±62.97 μm(F=-188.3, P〈0.01); in Group B, BCVA raised to 0.51±0.26(F=0.31, P〈0.01), CMT reduced to 261.93±50.15 μm(F=-201.9, P〈0.01). But there were no difference between two groups(P〉0.05). After phase III: in Group A, BCVA maintained 0.42±0.25(F=0.22, P=0.001), CMT maintained 267.8±58.34 μm,(F=-0.27, P〈0.01); in Group B, BCVA was 0.47±0.25(F=-0.27, P〈0.01), CMT was 272.71±49.16 μm(F=-191.1, P〈0.01). No serious complications happened in all phases.CONCLUSION: PRP+Conbercept is better than PRP+STTA in DME with proliferative stage but PRP+Conbercept+STTA sequential therapy may be a wiser choice for persistent effectiveness on anatomical as well as functional status.
AIM: To appraise the effect of treatment for diabetic macular edema(DME) in proliferative stage with sufficient panrentinal photocoagulation(PRP) therapy and intravitreal injections(IV) Conbercept and posterior subtenon's triamcinolone acetonide(STTA) sequential therapy.METHODS: This prospective clinical randomized controlled trial of cross-over design was conducted in three phases. The participants included cases of DME in proliferative stage. They were divided into two groups and treated with PRP before enrollment. Group A were treated with IVConbercept 0.5 mg for one month in the 1^st phase. Group B were treated with STTA 40 mg(twice per two weeks). The interventions were exchanged in the second phase(2mo) between the two groups. In the third phase(3-6mo) no other treatment was given. Best corrected visual acuity(BCVA), central macular thickness(CMT) measured by OCT and complications were compared.RESULTS: After phase I: in Group A, BCVA improved from 0.201±0.17 to 0.37±0.24(F=5.88, P=0.004). CMT changed from 449±155.10 to 304.1±84.70 μm(F=14.9, P〈0.01). In Group B, BCVA changed from 0.195±0.19 to 0.26±0.20(F=0.76, P=0.41) while CMT changed from 463.82±152.92 to 366.00±115.40 μm(F=3.70, P〈0.03). The improvement of BCVA was better in Group A(P〈0.05). After phase II: in Group A, BCVA raised to 0.47±0.27(F=0.26, P〈0.01), CMT reduced to 260.67±62.97 μm(F=-188.3, P〈0.01); in Group B, BCVA raised to 0.51±0.26(F=0.31, P〈0.01), CMT reduced to 261.93±50.15 μm(F=-201.9, P〈0.01). But there were no difference between two groups(P〉0.05). After phase III: in Group A, BCVA maintained 0.42±0.25(F=0.22, P=0.001), CMT maintained 267.8±58.34 μm,(F=-0.27, P〈0.01); in Group B, BCVA was 0.47±0.25(F=-0.27, P〈0.01), CMT was 272.71±49.16 μm(F=-191.1, P〈0.01). No serious complications happened in all phases.CONCLUSION: PRP+Conbercept is better than PRP+STTA in DME with proliferative stage but PRP+Conbercept+STTA sequential therapy may be a wiser choice for persistent effectiveness on anatomical as well as functional status.
基金
Supported by the Health and Family Planning Commission of Sichuan Province(No:17PJ536)