玻璃体腔单次注射康柏西普与曲安奈德治疗糖尿病黄斑水肿的短期疗效观察

Comparison Efficacy and Safety of Single Vitreal Injection Between Conbercept and Triamcinolone Acetonide for Diabetic Macular Edema

目的评价玻璃体腔单次注射抗血管内皮生长因子药物康柏西普及曲安奈德(TA)治疗糖尿病黄斑水肿(DME)的短期疗效。方法选择光学相干断层扫描(OCT)及眼底荧光血管造影(FFA)确诊为DME患者215例264眼,随机分为康柏西普组及TA组,每组各132眼。康柏西普组行玻璃体腔注射康柏西普0.05 ml(10 g/L),TA组玻璃体腔注射TA 0.1 ml(40 g/L)。术后1周、4周、12周观察两组视力、黄斑中心厚度(CMT)、眼压(IOP)及发生的并发症的比较。结果两组患者玻璃体注射后,玻璃体腔药物注射后1周、4周、12周视力与注射前比较均提高,差异有统计学意义(P<0.01);两组患者在玻璃体注射后各时间监测点的CMT值与注射前比较都减少,差异有统计学意义(P<0.01)。TA组玻璃体腔注射后各时间监测点眼压值都高于康柏西普组,差异有统计学意义(P<0.05,P<0.01),TA组患眼玻璃体腔注射后各时间监测点眼压值均高于注射前基线值(P<0.01)。TA组注射后眼压升高发生率为16.67%。结论康柏西普组及TA组玻璃体腔注射后相比,均能提高视力,减轻糖尿病黄斑水肿。康柏西普组安全性更好,TA组玻璃体腔注射后必须严密观察眼压。

Objective Compare the efficacy and safety of single vitreal injection between Conbercept and Triamcinolone acetonide(TA)for diabetic macular edema.Methods Total 215 patients(264 eyes)confirmed by optic coherence tomography(OCT)and fluorescein fundus angiography(FFA)as diabetic macular edema were randomly divided into Conbercept group and TA group,132 eyes for each group.Compaq Sipp of 0.05 ml(10 g/L)was injected into vitreous in Conbercept group and TA of 0.1 ml(40 g/L)was used at the same way.The visual acuity,central macular thickness(CMT)and intraocular pressure(IOP)were examined before and 1,4,12 weeks after injection.The complication after injection was compared between these two groups.Reaults The vision was obviously improved in both Conbercept group and TA group 1,4,12weeks after injection in comparison with that before injection(P<0.01).There was no difference found in CMT value between Conbercept group and TA group neither before nor after injection(P>0.05).However,the CMT values were reduced after injection compared with that before injection in both groups(P<0.01).1,4,12 weeks after injection,the IOPs were elevated in TA group compared with that of Conbercept group(P<0.05,P<0.01),and the IOP was higher after injection than that before injection in TA group(P<0.01).The incidence of the increased IOP after injection of TA was 16.67%.Conclusion Both Conbercept and TA can improve visual acuity and treat diabetic macular edema by intravitreal administration.Intravitreal injection of Conbercept is supposed to be safer than TA,and the IOP should be strictly monitored after injection.