577 nm激光光凝联合玻璃体内注射康柏西普治疗糖尿病性黄斑水肿的效果观察

Effect of 577 nm laser photocoagulation combined with intravitreal injection of conbercept on diabetic macular edema

目的探讨577 nm激光光凝联合玻璃体内注射康柏西普治疗糖尿病性黄斑水肿的效果。方法选取2016年1月至2017年3月在我院治疗的糖尿病性黄斑水肿患者81例81眼,根据患者最终选取的治疗方案分为观察组43例43眼和对照组38例38眼,观察组给予577 nm激光光凝联合玻璃体内注射康柏西普治疗,对照组仅给予577 nm激光光凝,观察两组治疗前后最佳矫正视力(best corrected visual acuity,BCVA)和黄斑中心凹厚度(central fovea of macula thickness,CMT),分析观察组BCVA和CMT变化值与初始因素的相关性。结果随治疗时间延长,观察组和对照组BCVA、CMT相应改善(均为P<0.05);观察组治疗后1个月、3个月和6个月BCVA分别为0.37±0.09、0.44±0.10和0.52±0.13,均明显高于对照组(均为P<0.05);观察组治疗后1个月、3个月和6个月CMT分别为(351.03±41.43)μm、(270.32±40.03)μm和(220.01±32.91)μm,均明显低于对照组(均为P<0.05);BCVA变化值与糖尿病性黄斑水肿病程、治疗前BCVA呈负相关(r=-0.422、-0.410,均为P<0.05);CMT变化值与糖尿病性黄斑水肿病程、治疗前CMT呈负相关(r=-0.430、-0.415,均为P<0.05)。结论 577 nm激光光凝联合玻璃体内注射康柏西普治疗糖尿病性黄斑水肿效果较好,其效果与患者基线BCVA、糖尿病性黄斑水肿病程有一定相关性。

Objective To investigate the effect of 577 nm laser photocoagulation combined with intravitreal injection of conbercept in the treatment of diabetic macular edema. Methods Totally 81 patients (81 eyes) with diabetic macular edema were selected in our hospital from January 2016 to March 2017,and the patients were divided into the observation group (43 patients 43 eyes) and the control group (38 patients 38 eyes) according to the patients’ final selection.The patients in the observation group were treated with 577 nm laser photocoagulation combined with intravitreal injection of conbercept,and the control group was treated with 577 nm laser photocoagulation only,and the best corrected visual acuity (BCVA) and central fovea of macula thickness (CMT) in the two groups before and after treatment were observed,and the correlation of BCVA and CMT changes in the observation group and initial factors were analyzed. Results The BCVA and CMT in the observation group and the control group improved with the prolongation of treatment time (all P<0.05).The BCVA at 1 months,3 months and 6 months after treatment in the observation group were 0.37±0.09,0.44±0.10 and 0.52±0.13,respectively,which were significantly higher than those in the control group (all P<0.05).The CMT at 1 months,3 months and 6 months after treatment in the observation group were (351.03±41.43)μm,(270.32±40.03)μm and (220.01±32.91)μm,respectively,which were significantly lower than that of the control group (all P<0.05).The change of BCVA was negatively correlated with the duration of diabetic macular edema and BCVA before treatment (r=-0.422 and -0.410,both P<0.05).The change of CMT were negatively correlated with the duration of diabetic macular edema and BCVA before treatment (r=-0.430 and -0.415,both P<0.05). Conclusion The effect of 577 nm laser photocoagulation combined with intravitreal injection of conbercept on diabetic macular edema is better,and the effect is related to the baseline visual acuity of the patients and duration of diabetic macular edema.