比较康柏西普和曲安奈德治疗视网膜静脉阻塞合并黄斑水肿的临床疗效

Comparison on clinical efficacy of conbercept and triamcinolone acetonide in the treatment of macular edema secondary to retinal vein occlusion

目的探讨玻璃体腔注射康柏西普(IVC)和后Tenon氏囊下注射曲安奈德(PSTA)治疗视网膜静脉阻塞(RVO)合并黄斑水肿的临床效果。方法74例(74眼)视网膜静脉阻塞并发黄斑水肿的患者,随机分为实验组36例(36眼)及对照组38例(38眼)。实验组行玻璃体腔注射康柏西普眼用注射液治疗,对照组行后Tenon氏囊下注射醋酸曲安奈德注射液治疗。比较两组患者治疗前及治疗后1、3、6个月的视力、黄斑中心凹厚度(CMT)、眼压水平,重复注射次数,并发症发生情况。结果治疗后1、3、6个月,两组患者的最佳矫正视力均优于本组治疗前,且实验组患者治疗后3、6个月的最佳矫正视力分别为(0.38±0.41)、(0.35±0.43),均优于对照组的(0.56±0.32)、(0.54±0.37),差异具有统计学意义(P<0.05)。治疗后1、3、6个月,两组患者的CMT均小于本组治疗前,且实验组治疗后1、3、6个月的CMT均小于对照组,差异具有统计学意义(P<0.05)。实验组治疗后1个月的眼压高于本组治疗前,对照组治疗后3个月的眼压高于本组治疗前,差异具有统计学意义(P<0.05)。两组患者的重复注射次数比较,差异无统计学意义(P>0.05)。术后随访6个月,两组患者均未发生严重并发症。结论对视网膜静脉阻塞合并黄斑水肿采用玻璃体腔注射康柏西普较后Tenon氏囊下注射曲安奈德可以给患者带来更好的视觉提高,更明显的降低黄斑中心凹的视网膜水肿厚度。

Objective To discuss the clinical effect of intravitreal injection of conbercept(IVC)and posterior sub-Tenon’s injection of triamcinolone acetonide(PSTA)in the treatment of macular edema secondary to retinal vein occlusion(RVO).Methods A total of 74 cases(36 involved eyes)of macular edema secondary to retinal vein occlusion were randomly divided into experimental group(36 cases,36 involved eyes)and control group(38 cases,38 involved eyes).The experimental group was treated with intravitreal injection of conbercept ophthalmic injection,and the control group was treated with posterior sub-Tenon’s injection of triamcinolone acetonide.The visual acuity,central macular thickness(CMT),intraocular pressure before treatment and 1,3,and 6 months after treatment,number of repeated injections and occurrence of complications were compared between the two groups.Results After 1,3 and 6 months of treatment,the best-corrected visual acuity of the two groups were better than those before treatment;the best-corrected visual acuity of the experimental group after 3 and 6 months of treatment were(0.38±0.41)and(0.35±0.43),which were all better than(0.56±0.32)and(0.54±0.37)of the control group;all the difference was statistically significant(P<0.05).After 1,3 and 6 months of treatment,the CMT of the two groups was less than those that before treatment,and the experimental group was less than the control group.All the difference was statistically significant(P<0.05).The intraocular pressure of the experimental group after 1 month of treatment was higher than that before treatment,and the intraocular pressure of the control group after 3 months of treatment was higher than that before treatment.All the difference was statistically significant(P<0.05).There was no statistically significant difference in number of repeated injections between the two groups(P>0.05).After 6 months of follow-up,no serious complications occurred in the two groups.Conclusion Compared with posterior sub-Tenon’s injection of triamcinolone acetonide,intravitreal injection of conbercept achieve better visual acuity and reduce the retinal edema thickness of macular fovea more significantly.