康柏西普治疗病理性近视脉络膜新生血管的临床分析

Clinical Analysis of Conbercept for Pathologic Myopic Choroidal Neovascularization

目的从结构和功能上分析玻璃体腔注射康柏西普治疗病理性近视(pathologic myopia,PM)合并脉络膜新生血管(choroidal neovascularization,CNV)的临床疗效。方法采用治疗前后自身对照、回顾性病例分析法研究玻璃体腔注射康柏西普治疗pm-CNV患者32例(32眼)的临床资料。治疗前后对患眼行最佳矫正视力(best corrected visual acuity,BCVA)、裂隙灯、眼压、眼底、光学相干断层扫描、荧光素钠眼底血管造影(fluorescence fundus angiography,FFA)检查,随访观察至术后12周。主要评价指标为患眼术前和术后4、8、12周BCVA(LogMAR视力)和黄斑中心厚度(central macular thickness,CMT)变化,以及药物相关并发症的发生情况。结果随访观察至12周,25眼FFA无明显荧光素钠渗漏,CMT恢复正常;5眼FFA荧光素钠渗漏减轻,CMT减低;2眼FFA荧光素钠渗漏加重,CMT增加。受试32眼共接受玻璃体腔注射康柏西普治疗64次,平均2.0次·眼-1,其中8眼治疗1次,16眼治疗2次,8眼治疗3次。患眼术前和术后4、8、12周的BCVA分别为0.73±0.44、0.62±0.41、0.54±0.39和0.53±0.40,总体比较差异有统计学意义(F=87.13,P<0.001);患眼术前和术后4、8、12周的CMT分别为(285.94±12.44)(265.41±11.79)(259.71±7.65)和(256.55±4.97)μm,总体比较差异有统计学意义(F=163.71,P<0.001)。术后有4眼暂时性眼压轻度升高,未见其他严重并发症的发生。结论从功能和结构两方面证实玻璃体腔注射康柏西普治疗pm-CNV安全有效且早期治疗尤为重要。

Objective To evaluate the clinical effect of intravitreal Conbercept injection on pathologic myopia complicated by choroidal neovascularization(pm-CNV)from the perspective of structure and function.Methods Clinical data of 32 pm-CNV patients(32 eyes)who underwent treatment with intravitreal Conbercept injection were analyzed retrospectively.The best corrected visual acuity(BCVA)test,slit-lamp biomicroscopy,intraocular pressure detection,optical coherence tomography and fundus fluorescein angiography(FFA)were performed before and after treatment.Patients were followed up for 12 weeks.The BCVA(LogMAR vision)and central macular thickness(CMT)were measured 4,8 and 12 weeks after injection.In addition,drug-related complications were recorded.Results A total of 64 times of intravitreal Conbercept injection were performed in the 32 eyes(average,2.0 times per eye),including 1 time of injection in 8 eyes,2 times of injection in 16 eyes and 3 times of injection in 8 eyes.After 12 weeks of treatment,FFA showed that fluorescein leakage disappeared and CMT returned to normal in 25 eyes,both fluorescein leakage area and CMT decreased in 5 eyes,and fluorescein leakage area expanded and CMT increased in 2 eyes.The BCVAs were respectively 0.73±0.44,0.62±0.41,0.54±0.39 and 0.53±0.40 before and 4,8 and 12 weeks after treatment,with significant difference among them(F=87.13,P<0.001).The CMTs were respectively(285.94±12.44)μm,(265.41±11.79)μm,(259.71±7.65)μm and(256.55±4.97)μm before and 4,8 and 12 weeks after treatment,with significant difference among them(F=163.71,P<0.001).There were 4 eyes with mild intraocular pressure increase after treatment.No other complications occurred in all patients.ConclusionFrom both functional and structural aspects,treatment with intravitreal Conbercept injection is safe and effective for pm-CNV.What’s more,early treatment is particularly important.