光动力疗法与玻璃体腔注射康柏西普治疗高度近视合并黄斑区脉络膜新生血管的疗效对比

Comparison of the efficacy of photodynamic therapy and intravitreal conbercept in the treatment of high myopia with choroidal neovascularization in macular area

目的:比较光动力疗法(PDT)与玻璃体腔注射康柏西普(IVC)治疗高度近视合并黄斑区脉络膜新生血管(CNV)的临床疗效。方法:收集2014年12月至2019年11月就诊于包头市眼科医院的高度近视合并CNV的患者29例共29只眼。按治疗方法分为A组(13只眼),B组(16只眼),A组行PDT治疗,B组行IVC治疗。门诊随访半年,记录最佳矫正视力(BCVA)及黄斑中心视网膜厚度(CRT)。结果:A组治疗前后BCVA均无差异。B组治疗后1周及1月BCVA提高,分别为:(0.204±0.088)、(0.268±0.139)(P=0.025、0.013)且术后1月时BCVA最好。A组治疗后1月、3月、6月时CRT均降低,分别为:(192.15±22.71)μm、(179.00±7.71)μm、(174.92±8.90)μm,与术前相比差异有统计学意义(P<0.05)。B组术后1月时CRT明显降低,为(160.56±47.03)μm,与术前相比差异有统计学意义(P<0.05)。A组与B组CRT相比:治疗后1月时B组下降较A组明显,差异有统计学意义(P<0.05)。结论:PDT治疗后患者视力改善不明显,但一定时间内可维持黄斑区功能,对于病情稳定有一定作用。IVC可在治疗后早期能提高患者视力,促进黄斑区渗漏及出血吸收,随时间延长,治疗效果不明显,甚至接近治疗前水平。在治疗后早期,IVC较PDT对于提高视力,改善黄斑区功能更具有意义。

Objective:Comparing the clinical efficacy of photodynamic therapy(PDT)and intravitreal of Compacept(IVC)in the treatment of high myopia with macular choroidal neovascularization(CNV).Methods:A total of 29 eyes of 29 patients with high myopia and CNV who were treated at Baotou Eye Hospital from December 2014 to November 2019 were collected.According to the treatment methods,they were divided into group A(13 eyes)and group B(16 eyes).Group A received PDT,and group B received IVC.Outpatient follow-up for six months,recorded the best corrected visual acuity(BCVA)and macular center retinal thickness(CRT).Results:There was no difference in BCVA before and after treatment in the PDT group.The BCVA increased 1 week and 1 month after treatment in IVC group,respectively:0.204±0.088,0.268±0.139(P=0.025,0.013),and BCVA was the best at 1 month after surgery.The CRT in the PDT group decreased at 1 month,3 months,and 6 months after treatment,respectively:192.15±22.71μm,179.00±7.71μm,174.92±8.90μm,there was significant difference compared with the preoperative(P<0.05),and in the IVC group was significantly lower at 1 month after operation,which was 160.56±47.03μm,the difference was statistically significant(P<0.05).Compared with CRT in PDT group and IVC group,the decrease in IVC group was more significant than that in PDT group at 1 month after treatment,and the difference was statistically significant(P<0.05).Conclusion:Visual acuity improvement after PDT treatment was not obvious,but within a certain period of time can be maintained macular function,have a role for stable condition.IVC can improve patients'vision early after treatment,promote leakage of macular area and absorption of bleeding.With time,treatment effect is not obvious,even close to the level before treatment.In the early post-treatment period,IVC is more meaningful than PDT for improving vision and improving macular function.