玻璃体腔内注射康柏西普治疗湿性老年性黄斑变性对视网膜神经纤维厚度的影响观察

Observation of the thickness on the retinal nerve fiber after treating with wet age-related macular degeneration by adopted intravitreal injection with Conbercept

目的观察康柏西普玻璃体腔注射治疗湿性老年性黄斑变性病变对于视网膜神经纤维厚度的影响。方法对2016年10月—2017年10月在汕头大学附属韶关市粤北人民医院采用康柏西普玻璃体腔注射治疗湿性老年性黄斑变性35例38眼中符合标准的患者18例(18眼)的临床资料进行回顾性分析,患者行最佳矫正视力、眼压(NCT)检查、OCT、荧光眼底血管造影(FFA)检查后,均接受0.05 mL康柏西普玻璃体腔注射,分别注射后1和2月观察患者最佳矫正视力(BCVA)、视网膜神经纤维厚度(RNFL)变化。结果 18眼共接受康柏西普玻璃体腔注射54次,所有患眼均注射3次。注射3个月后,OCT检查结果显示有18眼视力有提高,CRT厚度有下降。第1次注射时和注射后1个月、2个月的BCVA分别为0.1 (0.04,0.12),0.20 (0.10,0.30)和0.25 (0.12,0.30),总体比较差异有统计学意义(χ2=13.880,P<0.001);第1次注射时和注射后1个月、2个月的CRT (μm) 319.50(269.50,390.50), 271.00 (219.00,296.25)和234.50 (182.75,273.25)总体比较差异有统计学意义(χ2=11.978,P<0.05),第1次注射时和注射后1个月、2个月后的ARNFL (μm) 86.00 (76.25,98.00) 83.00 (76.00,95.50)和83.00 (76.25,94.75)总体比较差异无统计学意义(χ2=11.978,P>0.05),第1次注射时和注射后1个月、2个月眼压(kPa) 2.27 (1.97,2.44),16.0 (13.7,17.0),和2.00 (1.84,2.31)总体比较差异无统计学意义(χ2=1.604,P>0.05)。结论玻璃体腔注射康柏西普治疗湿性老年性黄斑变性对视网膜神经纤维厚度无明显的损害,安全且有效,但仍需要大样本量及长期随访观察。

Objective To observe the effect on the thickness of retinal nerve fibers in the patients with wet age-related macular degeneration by adopted intravitreal injection with Conbercept.Methods We analyzed 18 cases(18 eyes)that conform to the standard from 35 cases(38 eyes)retrospectively,who were treated with wet age-related macular degeneration by adopted intravitreal injection with Conbercept in Shaoguan Yuebei People's Hospital Affiliated to Shantou University from October in 2016 to October in 2017.After undergoing best corrected visual acuity(BCVA),intraocular pressure(IOP)and fluorescein angiography(FFA),all of them were adopted intravitreal injection with 0.05mL Conbercept.We observed the changes of best corrected visual acuity(BCVA)and retinal nerve fiber thickness(RNFL)after 1 and 2 months of adopted intravitreal injection with 0.05 mL Conbercept.Results 18 eyes were adopted intravitreal injection Conbercept 54 times totally.All the eyes were injected three times.After 3 months of injection,OCT showed that the visual acuity of 18 eyes improved and the thickness of CRT decreased.The BCVA values at the first injection,after the first injection and after the second injection were 0.1(0.04,0.12),0.20(0.10,0.30)和0.25(0.12,0.30)respectively.The overall difference was statistically significant(χ^2=13.880,P<0.001).CRT(μm)values at the first injection,after the first injection and after the second injection were 319.50(269.50,390.50),271.00(219.00,296.25)and 234.50(182.75,273.25)respectively.The overall difference was statistically significant(χ^2=11.978,P<0.05).ARNFL(μm)values at the first injection,after the first injection and after the second injection were 86.00(76.25,98.00),83.00(76.00,95.50)and 83.00(76.25,94.75)respectively.There was no significant difference(χ^2=11.978,P >0.05).The IOP(mmHg)values at the first injection,after the first injection and after the second injection were 17.0(14.8,18.3),16.0(13.7,17.0),和15.0(13.8,17.3)respectively.There was no significant difference(χ^2=1.604,P >0.05).Conclusion There was no obvious damage to the retinal nerve fiber by adopted intravitreal injection with Conbercept to treat the patients with wet age-related macular degeneration.That’s safe and effective,but need a large sample to follow-up for a longtime.