玻璃体腔注射康柏西普联合全视网膜光凝治疗进展型糖尿病性视网膜病变的效果观察

Effect Observation of Vitreous Injection of Compaq combined with Total Retinal Photocoagulation on Progressive Diabetic Retinopathy

目的:探讨玻璃体腔注射康柏西普联合全视网膜光凝治疗对进展型糖尿病性视网膜病变(DR)患者视神经纤维层(RNFL)厚度、黄斑厚度及视力的影响。方法:进展型DR患者76例,随机分为实验组和对照组,各38例。实验组给予玻璃体腔注射康柏西普联合全视网膜光凝治疗,对照组仅给予全视网膜光凝治疗。治疗前、后均通过相关检查获取RNFL厚度及黄斑厚度,检测血清血管内皮生长因子(VEGF)浓度,评估视力恢复效果及统计并发症发生情况。结果:两组治疗前RNFL厚度及黄斑厚度比较无统计学意义(P>0.05),治疗后均显著降低,且实验组视盘上方、下方、颞侧、鼻侧环状区平均RN-FL厚度、全周360°RNFL厚度以及黄斑厚度均显著低于对照组,差异有统计学意义(P<0.05)。两组治疗前血清VEGF浓度、BCVA比较无统计学意义(P>0.05),但与对照组相比,实验组治疗后7、14、28d各时间点血清VEGF浓度显著低,BCVA增高幅度明显大,差异有统计学意义(P<0.05)。实验组治疗后前房炎性反应、高眼压、角膜水肿、新生血管增生发生率均略低于对照组,但差异无统计学意义(P>0.05)。结论:全视网膜光凝治疗前给予玻璃体腔注射康柏西普有助于降低进展型DR患者RNFL厚度、黄斑厚度及血清VEGF浓度,从而显著改善视力。(DR)患者视神经纤维层(RNFL)厚度、黄斑厚度及视力的影响。方法:进展型DR患者76例,随机分为实验组和对照组,各38例。实验组给予玻璃体腔注射康柏西普联合全视网膜光凝治疗,对照组仅给予全视网膜光凝治疗。治疗前、后均通过相关检查获取RNFL厚度及黄斑厚度,检测血清血管内皮生长因子(VEGF)浓度,评估视力恢复效果及统计并发症发生情况。结果:两组治疗前RNFL厚度及黄斑厚度比较无统计学意义(P>0.05),治疗后均显著降低,且实验组视盘上方、下方、颞侧、鼻侧环状区平均RNFL厚度、全周360°RNFL厚度以及黄斑厚度均显著低于对照组,差异有统计学意义(P<0.05)。两组治疗前血清VEGF浓度、BCVA比较无统计学意义(P>0.05),但与对照组相比,实验组治疗后7、14、28d各时间点血清VEGF浓度显著低,BCVA增高幅度明显大,差异有统计学意义(P<0.05)。实验组治疗后前房炎性反应、高眼压、角膜水肿、新生血管增生发生率均略低于对照组,但差异无统计学意义(P>0.05)。结论:全视网膜光凝治疗前给予玻璃体腔注射康柏西普有助于降低进展型DR患者RNFL厚度、黄斑厚度及血清VEGF浓度,从而显著改善视力。

Objective： To investigate the effect of intravitreal injection of Conbercept combined with panretinal photocoagulation on the thickness of retinal nerve fiber layer（RNFL）,macular thickness and visual acuity in patients with progressive diabetic retinopathy（DR）. Methods： 76 patients with progressive DR were randomly divided into the experimental group and the control group,with 38 cases in each group. The former was treated by intravitreal injection of Conbercept combined with panretinal photocoagulation,while the latter was only treated with panretinal photocoagulation alone. The thickness of RNFL and macular thickness were obtained through related examinations before and after treatment. The concentration of serum vascular endothelial growth factor（VEGF） was detected,the recovery of visual acuity was evaluated,and the incidence of complications was statistically analyzed. Results： There was no significant difference in the thickness of RNFL and macular thickness between the two groups before treatment（P 0.05）. However,the thickness of RNFL and macular thickness were significantly decreased after the treatment,and the average RNFL thickness of the upper,lower,temporal and nasal side ring area of the optic disc,the thickness of whole-cycle 360 degrees RNFL and macular thickness in the experimental group were significantly lower than those in the control group（P0.05）. There was no significant difference in the concentration of serum VEGF and the BCVA between the two groups before treatment（P 0.05）. The concentration of serum VEGF in at the experimental group at 7 d,14 d and 28 d after treatment was significantly lower than that in the control group,and the increase of the BCVA was significantly greater than that in the control group（P 0.05）. The incidence rates of anterior chamber inflammatory reactions,intraocular hypertension,corneal edema and neovascularization in the experimental group after treatment were slightly lower than those in the control group（P 0.05）. Conclusion： Intravitreal injection of compaitcp before retinal photocoagulation helps to reduce the thickness of RNFL,macular thickness and serum VEGF concentration in progressive DR patients,thus improving visual acuity.