阿柏西普联合地塞米松玻璃体内植入剂治疗糖尿病黄斑水肿的临床疗效观察

Clinical effect observation of afibercept combined with dexamethasone intravitreal implant on diabetic macular edema

目的 探讨玻璃体腔注射阿柏西普联合地塞米松玻璃体内植入剂(dexamethasone intravitreal implant,DEX)治疗糖尿病黄斑水肿(diabetic macular edema,DME)的疗效。方法 选取2018年1月至2021年7月北京老年医院眼科经光学相干断层扫描和眼底荧光血管造影检查诊断为DME的患者74例(93眼),根据随机数字表法分为试验组38例(48眼)和对照组36例(45眼),分别玻璃体内注射阿柏西普联合DEX和阿柏西普,观察并比较两组患者术前、术后最佳矫正视力(best corrected visual acuity,BCVA)、黄斑中心凹视网膜厚度(central macular thickness,CMT)、注药间隔时间。结果 74例患者中男35例,女39例;年龄57~68岁,平均(63.7±4.6)岁。术后1个月、3个月和6个月时,试验组BCVA较对照组均有改善[(0.43±0.33)比(0.57±0.24),(0.31±0.19)比(0.42±0.21),(0.34±0.15)比(0.45±0.18)],且CMT较对照组均有下降[(322.34±89.10)μm比(387.16±91.27)μm,(282.21±92.10)μm比(332.27±85.35)μm,(274.35±95.16)μm比(327.25±90.27)μm],试验组平均注药间隔时间较对照组有增加[(9.07±2.15)周比(5.31±2.73)周],以上比较的差异均有统计学意义(P <0.05)。结论 玻璃体腔注射阿柏西普联合DEX可以改善DME患者的视力,降低CMT,延长注药间隔时间。

Objective To explore the effect of aflibercept combined with dexamethasone intravitreal implant(DEX) in the treatment of diabetic macular edema(DME).Methods A total of 74 patients(93 eyes) with DME diagnosed by optical coherence tomography and fluorescence fundus angiography in Beijing Geriatric Hospital from January 2018 to July 2021were selected,and were divided into the experimental group(38 cases with 48 eyes) treated with aflibercept combined DEX and the control group(36 cases with 45 eyes) treated with aflibercept according to the random number table method.The preoperative and postoperative best corrected visual acuity(BCVA),central macular thickness(CMT),injection interval were observed and calculated.Results There were 35 males and 39 females among the 74 patients,the age ranged from 57 to 68years old,with an average age of(63.7 ± 4.6) years old.At 1 month,3 months and 6 months after surgery,the BCVA of the experimental group were improved compared with those of the control group [(0.43 ± 0.33) vs.(0.57 ± 0.24),(0.31 ± 0.19) vs.(0.42 ± 0.21,)(0.34 ± 0.15) vs.(0.45 ± 0.18)].The CMT of the experimental group were lower than those of the control group[(322.34 ± 89.10) μ m vs.(387.16 ± 91.27) μ m,(282.21 ± 92.10) μ m vs.(332.27 ± 85.35) μ m,(274.35 ± 95.16) μ m vs.(327.25 ± 90.27) μ m],and the average injection interval of the experimental group was longer than that of the control group[(9.07 ± 2.15) weeks vs.(5.31 ± 2.73) weeks],and the difference was statistically significantau(P<0.05).Conclusions Intravitreal injection of aflibercept combined with DEX can improve visual acuity,reduce CMT and prolong injection interval in patients with DME.