PDT联合康柏西普治疗息肉状脉络膜血管病变1年疗效观察

Clinical observation of PDT combined withconbercept in the treatment of polypoid choroidal vascular disease followed-up for one year

目的探究光动力疗法(PDT)联合抗VEGF治疗息肉状脉络膜血管病变(PCV)患者的疗效,并评估其不良反应。方法回顾性分析2015年6月~2018年6月临床确诊的PCV患者33例(33眼),康柏西普组(12眼)、PDT组(11眼)和康柏西普+PDT组(10眼)。比较三组最佳矫正视力、眼底造影检查、CMT和不良反应发生情况,并随访1年复查患者远期疗效评估。结果治疗前1 d三组患者BCVA比较,差异没有统计学意义(P>0.05)。而经联合治疗后1月、2月、3月,康柏西普+PDT组患者的BCVA均优于其他2组,治疗1年后,康柏西普+PDT组和康柏西普组患者BCVA差异无统计学意义(P>0.05),均优于PDT治疗组。治疗前1d三组CMT比较,差异没有统计学意义(P>0.05)。治疗后1月~3月,抗VEGF+PDT组CMT与抗VEGF组和PDT组比较显著降低(P<0.05),抗VEGF+PDT组治疗后不良发生率为40.00%,而抗VEGF组发生率为41.67%,PDT组为72.72%。治疗后随访1年,抗VEGF+PDT组治疗后息肉病灶减少率(70.0%)明显较抗VEGF组(33.3%)和PDT组(54.5%)升高(P<0.05)。结论抗VEGF联合PDT治疗PCV安全有效,有利于提高患者的视力,减轻视网膜水肿,降低CMT,减少息肉灶,减少抗VEGF药物的注射次数。

Objective To investigate the efficacy of photodynamic therapy(PDT)combined with anti-VEGF in the treatment of Polypoidal choroidal vasculopathy(PCV)and to evaluate the adverse reactions.Methods From June 2015 to June 2018,33 patients(33 eyes)with PCV complicated with vitreous blood were analyzed retrospectively.They were divided into the anti-VFGF group(12 eyes),the PDT group(11 eyes)and the anti-VEGF+PDT group(10 eyes).The best corrected visual acuity,fundus angiography(CMT)and adverse reactions were compared between the three groups,and the results were followed up for 1 year.Long-term efficacy evaluation of patients.Results In 1~3 months after treatment,BCVA in the anti-VEGF+PDT group was significantly higher than that in the other 2 groups.After one year of treatment,there was no significant difference in BCVA between conbercept+PDT group and conbercept group(P>0.05).The CMT in the anti-VEGF+PDT group was significantly lower than that in the other two groups(P<0.05).After treatment,the adverse incidence anti VEGF+PDT group was 40.00%,and anti-VEGF group was 41.67%,the PDT group was 72.72%.Follow-up of 1 year after treatment,the anti VEGF+PDT group decrement polypus lesions(70.0%)were significantly higher than anti VEGF group(33.3%)and PDT higher(54.5%)(P<0.05).Conclusion Anti-VEGF combined with PDT is safe and effective in the treatment of PCV,which is beneficial to improve the visual acuity of patients to alleviate retinal edema,reduce CMT and reduce polyp foci,decline the number of injections of anti VEGF drugs.