PRP联合玻璃体腔注射康柏西普治疗重度NPDR对视神经纤维层厚度的影响

Effect of intraocular injection of Conbercept on the thickness of optic nerve fiber layer in the treatment of severe NPDR

目的比较分析玻璃体腔注射康柏西普联合全视网膜激光光凝术(PRP)以及单纯PRP治疗重度非增生性糖尿病视网膜病变(NPDR)对视盘周围视网膜神经纤维层(RNFL)厚度的影响。方法回顾性病例对照研究。分析2019年1月至6月我院重度NPDR患者需行PRP治疗的60例(60只眼),随机分为实验组30例(30只眼)(PRP治疗前1周进行玻璃体腔注射康柏西普0.05 ml)及对照组30例30只眼(直接进行PRP),分析两组患者PRP治疗前和治疗后4周、6个月其上方、下方、鼻侧、颞侧RNFL及全周RNFL的平均厚度。结果两组治疗前、治疗后4周及6个月比较,RNFL厚度各象限及全周平均差异有统计学意义(P<0.001);与治疗前比较,治疗后4周两组RNFL厚度各象限及全周平均均增厚,对照组RNFL厚度增加有统计学意义(P<0.05),而实验组厚度增加差异无统计学意意义(P>0.05);与治疗前比较,治疗后6个月两组厚度各象限及全周平均均变薄,两组差异均有统计学意义(P<0.05),两组RNFL厚度比较差异无统计学意义(P>0.05)。结论PRP联合玻璃体腔注射康柏西普治疗重度NPDR短期内可以减轻对患者视神经纤维层厚度的影响,显著提高了PRP的疗效和安全性。

Objective To compare and analyze the effects of intraocular injection of conbercept combined with PRP and PRP alone in the treatment of severe NPDR on the thickness of RNFL.Methods 60 patients(60 eyes)with severe NPDR in our hospital who need PRP treatment from January 2019 to June 2019 were randomly divided into 30 eyes in the experimental group(0.05ml intraocular injection of conbercept 1 week before PRP)and 30 eyes in the control group(direct PRP).The average thickness of RNFL above,below,nasal,temporal and whole RNFL in the two groups before and at 4 weeks and 6 months after PRP were analyzed.Results Compared before treatment,4 weeks and 6 months after treatment,the average difference of RNFL thickness in each quadrant and the whole was statistically significant(P<0.001).Compared with before treatment,the average thickness of RNFL in each quadrant and the whole of the two groups increased 4 weeks after treatment,and the increase of RNFL thickness in the control group was statistically significant(P<0.05),but there was no significant difference in the increase of RNFL thickness in the experimental group(P>0.05).Compared with before treatment,the average thickness of the two groups decreased in each quadrant and the whole week at 6m after treatment,and the difference between the two groups was statistically significant(P<0.05),but there was no significant difference in the thickness of RNFL between the two groups(P>0.05).Conclusions PRP combined with intraocular injection of conbercept can reduce the impact on the thickness of optic nerve fiber layer in patients with severe NPDR in a short time,and significantly improve the efficacy and safety of PRP.