康柏西普治疗视网膜分支静脉阻塞所致黄斑水肿患者光感受器形态学改变对视力预后的影响

Effect of conbercept on visual prognosis of patients with macular edema caused by branch retinal vein occlusion

目的探讨康柏西普治疗视网膜分支静脉阻塞(BRVO)所致黄斑水肿(ME)患者光感受器形态学改变对视力预后的影响。方法选取2019年6月至2020年6月在湖北医药学院附属人民医院诊治的BRVO-ME患者100例作为研究对象,经玻璃体腔内注射康柏西普眼用注射液0.05 mL,1周后行532 nm黄斑格栅样激光光凝治疗。随访6个月期间,每个月至少检查1次,比较患者治疗前及治疗后第1、2、3、6个月最佳矫正视力(BCVA)、中心视网膜厚度(CRT)、感光细胞层厚度(PLT)及外核层厚度(ONLT)结果;患者治疗前及治疗后6个月BCVA与CRT、PLT、ONLT的相关性分析;观察治疗后1个月内并发症的发生情况。结果患者治疗后各随访时间点的BCVA高于治疗前(P<0.05)。患者治疗后第1、2、3、6个月CRT、PLT及ONLT值低于治疗前(P<0.05)。患者治疗前BCVA与CRT、ONLT呈正相关关系(r=0.614和0.502,P=0.000和0.001),而BCVA与PLT无相关性(r=0.081,P=0.571)。患者治疗6个月后BCVA与PLT呈负相关关系(r=-0.345,P=0.010),而BCVA与CRT、ONLT无相关性(r=0.006和0.161,P=0.991和0.258)。患者治疗后1个月内仅有10例(10.00%)出现过性眼压增高。结论康柏西普可促进BRVO所致黄斑水肿患者视力恢复及水肿吸收,其可为临床治疗BRVO所致ME提供一定的科学依据。

【Objective】To explore the influence of treating photoreceptor morphology changes in patients with macular edema(ME)caused by branch retinal vein occlusion(BRVO)conbercept on the prognosis of vision.【Methods】One hundred patients with ME caused by BRVO who were diagnosed and treated in our hospital from June 2019 to June 2020 were selected as the research object.Intravitreal injection of 0.05 mL of Conbercept Ophthalmic Injection,and 532 nm macular grille-like laser photocoagulation was performed after 1 week.During the 6-month follow-up,patients were checked at least once a month.Best corrected visual acuity(BCVA),central retinal thickness(CRT),photoreceptor layer thickness(PLT),outer nuclear layer thickness(ONLT)before and 1,2,3,6 months after treatment were compared.Correlation between BCVA and CRT,PLT,ONLT before treatment and 6 months after treatment was analysed.The occurrence of complications within 1 month after treatment was observed.【Results】The BCVA at each follow-up time point after treatment was higher than before treatment(P<0.05).Compared with before treatment,the values of CRT,PLT and ONLT decreased 1,2,3,and 6 months after treatment,and the difference was statistically significant(P<0.05).According to Spearman correlation analysis,there was a linear positive correlation between BCVA and CRT,ONLT before treatment,but no correlation between BCVA and PLT;there was a linear negative correlation between BCVA and PLT after 6 months of treatment,but no correlation between BCVA and CRT,ONLT.Within 1 month after treatment,only 10 patients(10.00%)experienced transient intraocular pressure increase,and no obvious ocular adverse events such as corneal edema,and long-term ocular hypertension were observed.【Conclusion】Conbercept can promote the recovery of vision and absorption of edema in patients with macular edema caused by BRVO,and provide a certain scientific basis for the clinical treatment of macular edema caused by BRVO.