观察康柏西普联合激光光凝治疗糖尿病性黄斑水肿临床疗效

Clinical effect of Conbercept intravitreal injection combined with macular grid laser photocoagulation on the treatment of diabetic macular edema

目的观察玻璃体腔内注射Conbercept联和黄斑区格栅样光凝治疗糖尿病性黄斑水肿(diabetic macular edema,DME)的临床疗效。方法选取2016年1月至2017年1月在安徽省第二人民医院眼科就诊经荧光素眼底血管造影(FFA)和光学相干断层扫描技术(OCT)等眼科检查确诊为fluoresce in fundus angiography optical coherence tomography DME的40例患者40只眼。按治疗方案的不同分为试验组和对照组,所有患者按"3+PRN"方案行玻璃体腔内注射Conbercept,每次注射剂量为Conbercept后1周给予黄斑区格栅样光凝,0.05ml;试验组在第一次注射治疗对比分析治疗前后最佳矫正视力(Best corrected visua lacuity,BCVA)及黄斑中心凹厚度(central macular thickness,CMT)变化。结果 1、两组患眼平均BCVA较治疗前均提高,差异有统计学意义(t=15.536、13.208、12.729、11.201,P<0.05;t=6.903、11.184、12.550、10.053,P<0.05)。两组患眼平均CMT较治疗前均降低,差异有统计学意义(t=24.531、22.120、22.566、21.596,P<0.05;t=23.540、26.268、29.298、28.032,P<0.05).2、对两组患者的BCVA和CMT分别采用两因素重复测量方差分析,两;组BCVA和CMT在组间的处理效应和时间效应的交互作用没有统计学意义;3注药次数比较:试验组平均注药次数为(.80±0.616)次,对照组平均注药次数为(4.30±0.571)次,差异有统计学意义(t=2.127,0.05)。3 P<结论单纯玻璃体腔注射康柏西普及联合黄斑区格栅样光凝治疗DME均有效,可提高患眼视力,改善视觉质量,减轻黄斑水肿;联合治疗可减少玻璃体腔注药次数;

Objective To investigate the clinical effect of conbercept intravitreal injection combined with macular grid laser photocoagulation on the treatment of diabetic macular edema（DME）. Methods From January in 2016 to January in 2017, after the diagnosis was confirmed by fundus fluorescein angiography （FFA） optical coherence tomography （OCT） and others＇ ophthalmic examinations,40 patients（40 eyes） from department of ophthalmology in the Second People＇ s Hospital of Anhui Province with DME were randomly divided into experiment group （20 cases） and control group（20 cases）. All affected eyes were injected by conbercept , following a ＇ 3＋PRN＇ schedule intravenously and treated with 0.05 ml. The experiment group received retinal laser macular grid laser photocoagulation 1 week after the intravitreal injection of Conbercept. The central macular thickness （CMT） and best corrected visual acuity （ BCVA ） of two groups before and after treatments were compared. Results 1, The mean BCVA of two groups were all improved. There was a significant difference between each follow-up time and baseline（t=15.536, 13.208, 12.729, 11.201, P〈 0.05; t=-6.903, 11.184, 12.550, 10.053, P 〈 0.05 ） . The mean CMT of two groups were significantly decreased at each follow-up time compared with baseline （ t =24.531, 22.120, 22.566, 21.596, P〈 0.05; t=23.540, 26.268, 29.298, 28.032, P〈 0.05 ） 2, The ANOVA for two-way repeated measures was used to analyze the data of BCVA and CMT between two groups.The results showed that the interaction between treatment effects and time effects in BCVA and CMT didn＇ t have statistically significant. 3, The comparison of the number of intravitreal injection： the mean number of intravitreal injection of experiment group and control group were（3.80±0.616 and 4.30±0.571）, There was statistically significant （t=2.127, P〈0.05）. Conclusion The treatments of Conbercept intravitreal injection combined with macular grid laser photocoagulation and only Conbercept intravitreal injection on the treatment of DME were effective.,and it also can improve visual acuity, reduce macular edema,but combined the treatment can reduce the frequency of intravitreal injection.