抗VEGF药物康柏西普治疗病理性近视脉络膜新生血管的疗效观察

To evaluate the efficacy of Conbercept for choroidal neovascularization secondary to pathologic myopia

目的观察玻璃体腔注射抗血管内皮生成因子(Antivascularendothelialgrowthfactor,AntiVEGF)药物康柏西普治疗病理性近视(pathologicmyopia,PM)继发脉络膜新生血管(choroidalneovascularization,CNV)的临床疗效及安全性。方法回顾性病例研究,经最佳矫正视力(bestcorrectedvisualacuity,BCVA)、验光、前置镜下眼底检查、光相干断层扫描(opticalcoherencetomography,OCT)、荧光素眼底血管造影(fundusfluoresceinangiograph,FFA)联合吲哚青绿血管造影(IndocyanineGreenAngiography,ICGA)检查确诊为PM继发CNV的20例患者20只眼纳入研究。所有患者均行玻璃体腔内注射康柏西普0.5mg/0.05mL,治疗后每月随访1次,随访12个月,根据每次随访所见的BCVA、视网膜中央厚度(centralmacularthickness,CMT)、视网膜下积液、CNV渗漏等变化情况确定是否需重复治疗,对比观察治疗前后BCVA、CMT的变化。结果患眼平均治疗次数为1.8次,治疗前最佳矫正视力(BCVA)平均13.30±4.42个字母;末次随访BCVA平均55.50±6.72个字母,较治疗前提高42.20±7.67个字母,差异有统计学意义(t=17.39,P<0.05);治疗前CMT平均402.80±21.96μm,末次随访平均CMT为224.90±6.95μm,较治疗前下降177.90±23.26μm,差异有统计学意义(t=24.18,P<0.05)。随访期间所有患者均未发生眼内炎、视网膜脱离、白内障、继发性青光眼等与药物、注射相关的眼部和全身不良事件。结论玻璃体腔注射康柏西普治疗病理性近视CNV是安全有效的,可消退脉络膜新生血管,促进视网膜出血、水肿吸收,提高患者的视力,无与治疗相关的不良事件发生。

ObjectiveTo evaluate the efficacy of intravitreal injections of conbercept in choroidal neovascularization(CNV)secondary to pathologic myopia(PM).MethodsRetrospective study.20patients(20eyes)with CNV secondary to PM were treated by intravitreal injections of conbercept0.05ml(10mg/ml).Before the injection,best corrected visual acuity(ETDRS)chart,optometry,ophthalmoscope,optical coherence tomography(OCT),Fluorescein and Indocyanine Green Angiography examination were taken.Follow up visits were performed monthly after injection for12months.Injections were repeated according to the situation of BCVA,CMT,subretinal fluid and CNV leakage during follow up.The values of BCVA and CMT were compared before and after treatment.ResultsAll eyes received1.8times of injections on average.The initial average letters of BCVA were13.30±4.42,average CMT was402.80±21.96μm,the final average letters of BCVA were55.50±6.72,increased42.20±7.67letters than before(t=17.39,P<0.05=,average CMT was224.90±6.95μm,decreased177.90±23.26μm(t=24.18,P<0.05=.There were no systemic or ocular serious side effects during the follow up,such as Endophthalmitis,retinal detachment,cataract,secondary glaucoma etc.ConclusionIntravitreal injections of Conbercept was effective and safe for choroidal neovascularization secondary to pathologic myopia.