玻璃体腔注射康柏西普治疗视网膜静脉阻塞的临床观察及视力恢复的预测因素分析

The clinical observation of Conbercept intravitreal injection for the treatment of retinal vein occlusion and analysis of prognosis of visual recovery

目的观察、评估玻璃体腔注射康柏西普治疗视网膜静脉阻塞(RVO)继发黄斑水肿的疗效和安全性,并探讨其视力恢复的相关因素。方法将确诊为RVO继发黄斑水肿的患者50例(50只眼)纳入研究,其中视网膜中央静脉阻塞(CRVO)16例(16只眼),视网膜分支静脉阻塞(BRVO)34例(34只眼)。采用康柏西普0.05 ml玻璃体腔注射治疗,每个月1次,随后根据患者病情判定是否继续注射,随访6个月。比较治疗前后最佳矫正视力(BCVA)、黄斑中心凹视网膜厚度(CMT)的变化,并观察术后有无并发症的发生。将最终视力恢复值(FVG)分别从性别、年龄、病程、治疗前BCVA、CMT及有无系统疾病等方面分析以评价术后视力恢复的影响因素。结果 CRVO和BRVO患者治疗后平均BCVA、CMT较治疗前均明显好转(P<0.05),眼底观察示治疗后视网膜出血量较前明显减少,荧光素眼底血管造影示视网膜无明显渗漏。在所有151次注射中,发生术后局部球结膜下出血5次(5只眼),角膜上皮损伤2次(2只眼),未发生其他并发症。治疗前BCVA、病程与FVG呈正相关。结论玻璃体腔注射康柏西普治疗RVO继发黄斑水肿安全有效。治疗前BCVA及病程是术后视力恢复的预测因素。

Objective To observe and evaluate the clinical efficacy and safety of Conbercept intravitreal injection in patients with macular edema secondary to retinal vein occlusion（ RVO） and to investigate the factors associated with visual recovery. Methods 50 patients（50 eyes） with RVO diagnosed enrolled in this study,including 16 cases（16 eyes） of central retinal vein occlusion（ CRVO） and 34 cases（34 eyes） of branch retinal vein occlusion（ BRVO）. All patients received intravitreal injection of 0. 05 ml Conbercept,once per month. Further injection may be required if patients＇ follow-up indicated. The follow-up duration was six months. To compare the best corrected visual acuity（ BCVA） and central macular thickness（ CMT） before and after treatment. Postoperative adverse reactions were observed. The final visual gain（FVG） were evaluated based on sex,age,duration,baseline BCVA,baseline CMT,and presence or absence of systemic diseases to identify the associated predictors of visual recovery. Results The average BCVA and the mean CMT of patients with CRVO and BRVO after treatment was significantly better than that before treatment（ P 0. 05）. Fundus observation showed that hemorrhage absorbed significantly decreased,fundus fluorescein angiography showed an obvious decrease in retinal leakage. Subconjunctival hemorrhage occurred in 5 patients,and corneal epithelium damaged in 2 patients. There were no other serious adverse complication. Baseline BCVA,duration were positively associated with FVG. Conclusions The intravitreal injection of Conbercept in patients with ME secondary to RVO is safe and effective. Baseline BCVA and duration are the predictive factors of the visual recovery.