基于EDI-OCT和OCTA评价康柏西普治疗息肉样脉络膜血管病变的疗效

Efficacy of conbercept in the treatment of polypoidal choroidal vasculopathy based on EDI-OCT and OCTA

目的基于频域相干光断层深度增强技术(EDI-OCT)和光学相干断层扫描血管成像(OCTA)评价康柏西普治疗息肉样脉络膜血管病变(PCV)前后的视网膜厚度、脉络膜厚度及脉络膜血管息肉样病变(polyps)的变化。方法选取2019年1月至2020年12月新疆医科大学附属中医医院眼科收治的PCV患者20例(既往未进行玻璃体腔注药),予以康柏西普玻璃体腔内注射,采用3+PRN的治疗方案;观察患者治疗前后的视力、眼压、黄斑区中心凹范围内厚度(CMT)、黄斑中心凹下脉络膜厚度(SFCT)、视乳头周围脉络膜厚度(PCT)、polyps高度、polyps最大横截面积的变化情况。结果20例患者治疗前后的最佳矫正视力(BCVA)、CMT、SFCT、PCT、polyps高度、polyps最大横截面积比较差异有统计学意义(均P<0.05)。治疗后1周及1个月患者BCVA明显改善(均P<0.05),治疗后6个月仍有改善,但与治疗后3个月相比差异无统计学意义(P>0.05),治疗后6~12个月略有波动,但基本稳定。CMT、SFCT、PCT在治疗3个月明显降低,治疗后6~12个月基本稳定。治疗后1个月polyps高度为(251.30±57.49)μm,较基线下降11.3μm,治疗后3、6、12个月均有不同程度下降,差异有统计学意义(均P<0.05)。治疗后3、12个月polyps最大横截面积分别为(2.10±0.44)μm^(2)、(1.98±0.44)μm^(2),均有一定程度的下降,差异有统计学意义(均P<0.05)。结论康柏西普眼内注射可以在治疗后3个月有效地降低PCV患者CMT、SFCT、PCT、polyps高度、polyps最大横截面积,提高BCVA;基于EDI-OCT和OCTA可定量检测PCV各项指标的变化,观察疗效及预后。

Objective To evaluate the changes of retinal thickness,choroid thickness and choroid vascular polypoid lesions(polyps)before and after the treatment of conbercept in polypoidal choroidal vasculopathy(PCV)with conbercept based on enhanced-depth imaging optical coherence tomography(EDI-OCT)and OCT angiography(OCTA).Methods Twenty patients with PCV admitted to the ophthalmology department of the Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University from January 2019 to December 2020(who had not received intravitreous injection before)were selected and given intravitreous injection of conbercept with 3+pro re nata(PRN)treatment.The changes of visual acuity,intraocular pressure,central macular thickness(CMT),subfoveal choroidal thickness(SFCT),peripapillary choroid thickness(PCT),polyps height,and maximum cross-sectional area of polyps were observed before and after treatment.Results There were significant difference in the best corrected visual acuity(BCVA),CMT,SFCT,PCT,polyps height and maximum polyps cross-sectional area before and after treatment in 20 patients(all P<0.05).BCVA was significantly improved at 1 week and 1 month after treatment(all P<0.05),and still improved at 6 months after treatment,but the difference was not statistically significant compared with 3 months after treatment(P>0.05),and slightly fluctuated at 6 to 12 months after treatment,but basically stable.CMT,SFCT and PCT decreased significantly after 3 months of treatment,and were basically stable from 6 to 12 months after treatment.One month after treatment,polyps height was(251.30±57.49)μm,with a decrease of 11.3μm;the polyps height decreased at 3,6 and 12 months after treatment,and the difference was statistically significant(all P<0.05).The maximum cross-sectional area of polyps at 3 and 12 months after treatment was(2.10±0.44)μm^(2) and(1.98±0.44)μm^(2),respectively,with a certain degree of decrease,and the difference was statistically significant(all P<0.05).Conclusions Intraocular injection of conbercept can effectively reduce CMT,SFCT,PCT,polyps height,maximum cross-sectional area of polyps and increase BCVA in PCV patients 3 months after treatment.EDI-OCT and OCTA were used to quantitatively detect the changes of PCV indexes and observe the curative effect and prognosis.