康柏西普治疗视网膜中央静脉阻塞的疗效与安全性的临床观察

CLINICAL STUDY ON THE EFFICACY AND SAFETY OF INTRAVITREAL INJECTION OF CONBERCEPT IN THE TREATMENT OF CENTRAL RETINAL VEIN OCCLUSION

目的评价康柏西普治疗视网膜中央静脉阻塞(CRVO)的疗效与安全性研究。方法临床病例治疗前后对照研究。对2016年1月—2017年6月就诊于该院眼科已确诊为视网膜中央静脉阻塞,全身一般情况尚可,无严重心脑血管等全身疾病和局部手术禁忌证的86例(86眼)患者纳入研究。对患眼均给予玻璃体腔注射康柏西普,必要时给予重复注射。观察术前和术后1周、1个月、2个月、3个月时患者的最佳矫正视力(best corrected visual acuity,BCVA)、光学相干断层(OCT)扫描测定黄斑中心凹区视网膜厚度(central macular thickness,CMT)、荧光素血管造影(fundus fluorescein angiography,FFA)及患者药物相关的眼部并发症及全身不良反应等情况。结果在86眼中视力提高者83眼,占96.5%。视力稳定者3眼,占3.5%。治疗后1周、1个月、2个月、3个月时分别为0.92±0.22、0.88±0.24、0.70±0.29、0.49±0.27,与治疗前相比差异均具有统计学意义。治疗前CMT为(528.23±138.23)μm,治疗后1周,1个月、2个月、3个月后CMT分别为(373.47±117.44)μm、(303.26±104.73)μm、(277.27±101.98)μm、(206.73±87.20)μm,与治疗前相比差异均具有统计学意义。对所有患者随访3个月后,行FFA检查,黄斑区渗漏完全消失81例(94.2%),黄斑区有渗漏现象但明显减轻5例(5.8%)。尚未发现与药物相关的眼部继发症及全身不良反应。结论玻璃体腔注射康柏西普能在短期内治疗CRVO是安全有效的,可以有效的改善黄斑水肿,提高患者视力,改善生活质量。

Objective To evaluate the efficacy and safety of Conbercept in the treatment of central retinal vein occlusion.Methods A comparative study of clinical cases before and after treatment was performed.Totally 86 eyes of 86 patients with central retinal vein occlusion in author＇s hospital from January 2016 to June 2017 were selected,who were in good condition and without serious cardiovascular and other systemic diseases and local surgical contraindication.The eyes were treated with Conbercept,when necessary to repeat injection.The best corrected visual acuity（BCVA）,central macular thickness（CMT）,fundus fluorescein angiography（FFA）and drug-induced the eye of comptucation and systemic adverse reactions of all patients in 1 week,1month,2 months and 3 months after injection respectively,were recorded and compared with pretherapy.Results In 86 eyes,the visual acuity was improved in83 eyes,accounting for 96.5%,visual acuity was stable in 3 eyes,accounting for 3.5%.After intravitreal injection of Conbercept 1 week,1 month,2 months and 3 months,BCVA was 0.92±0.22,0.88±0.24,0.70±0.29,0.49±0.27,and the difference was statistically significant compared with that before treatment.The CMT was（528.23±138.23）μm,after intravitreal injection of Conbercept 1 week,1 month,2 months and 3 months,the CMT was（373.47±117.44）μm,（303.26±104.73）μm,（277.27±101.98）μm,（206.73±87.20）μm,the CMT was thinner than prior treatment,statistical analysis was significant（P〈0.05）.All the patients were followed up for 3 months,and FFA examination showed that the macular leakage completely disappeared in all the patients were 81 patients（94.2%）,and a significant decrease in the macular area were 5 patiens（5.8%）.Drug related ocular complications and systemic adverse reactions had not been found.Conclusion In the short term,intravitreal injection of Conbercept in the treatment of CRVO is safe and effective,can effectively improve the macular edema and the visual acuity.