康柏西普治疗病理性近视脉络膜新生血管与湿性年龄相关性黄斑变性效果比较

EFFICACY OF CONBERCEPT IN TREATMENT OF PATHOLOGICAL MYOPIC CHOROIDAL NEOVASCULARIZATION VERSUS WET AGE-RELATED MACULAR DEGENERATION

目的比较玻璃体腔注射康柏西普治疗病理性近视脉络膜新生血管(pathological myopia choroidal neovascularization,pmCNV)与湿性年龄相关性黄斑变性(wet age-related macular degeneration,wAMD)的效果。方法回顾性分析2020年1月—2021年1月我院眼科经玻璃体腔注射康柏西普治疗的14例pmCNV患者和25例wAMD患者的临床资料,收集两组患者治疗前及首次治疗后半年时的最佳矫正视力(BCVA)、黄斑中心凹视网膜厚度(CMT),并分析近黄斑中央凹处外界膜(ELM)、椭圆体带(EZ)的完整性,将ELM和EZ完整性情况标记为ELM(+)和EZ(+),计算其构成比。结果与治疗前相比较,两组患者治疗后BCVA均有明显提高(Z=-2.272、-3.531,P<0.05),且pmCNV组患者BCVA治疗前后差值明显高于wAMD组(Z=-2.187,P<0.05)。与治疗前相比,两组治疗后CMT均明显降低(Z=-2.291、-3.511,P<0.05),但与pmCNV组患者相比wAMD组患者CMT治疗前后的差值更大(Z=-2.137,P<0.05)。另外与治疗前相比两组患者的ELM(+)和EZ(+)的构成比均升高(χ^(2)=4.038~7.000,P<0.05)。两组患者术前、术后BCVA(LogMAR)与ELM(+)和EZ(+)的构成比呈负相关(r=-0.754~-0.559,P<0.05)。结论定期玻璃体腔注射康柏西普对继发于病理性近视与湿性AMD的近中央凹处的CNV可产生良好治疗效果。与wAMD患者相比,pmCNV患者获得了更好的预后视力。

Objective To investigate the efficacy of intravitreal injection of conbercept in the treatment of pathological myopic choroidal neovascularization(pmCNV)versus wet age-related macular degeneration(wAMD).Methods A retrospective analysis was performed for the clinical data of 14 patients with pmCNV and 25 patients with wAMD who received intravitreal injection of conbercept in Department of Ophthalmology in our hospital from January 2020 to January 2021,including best corrected visual acuity(BCVA)and central macular thickness(CMT)before treatment and at half a year after first treatment.The integrity of external limiting membrane(ELM)and ellipsoidal zone(EZ)near the fovea centralis was analyzed,with intact ELM and EZ recorded as ELM(+)and EZ(+),respectively,and their constituent ratios were calculated.Results Both groups had a significant increase in BCVA after treatment(Z=-2.272,-3.531,P<0.05),and compared with the wAMD group,the pmCNV group had a significantly greater increase in BCVA after treatment(Z=-2.187,P<0.05).After treatment,both groups had a significant reduction in CMT(Z=-2.291,-3.511,P<0.05),but compared with the wAMD group,the pmCNV group had a significantly greater reduction in CMT after treatment(Z=-2.137,P<0.05).In addition,both groups had significant increases in the constituent ratios of ELM(+)and EZ(+)after treatment(χ^(2)=4.038-7.000,P<0.05).BCVA(LogMAR)was negatively correlated with the constituent ratios of ELM(+)and EZ(+)before and after surgery in both groups(r=-0.754--0.559,P<0.05).Conclusion Regular intravitreal injection of conbercept has a good clinical effect on choroidal neovascularization near the fovea centralis secondary to pmCNV or wAMD.Compared with the patients with wAMD,the patients with pmCNV obtain better visual acuity.