康柏西普玻璃体腔内注射联合激光光凝治疗糖尿病性黄斑水肿的疗效观察

Clinical observation of intravitreal conbercept combined laser photocoagulation for treatment of diabetic macular edema

目的 比较康柏西普玻璃体腔内注射联合激光光凝治疗糖尿病性黄斑水肿(diabetic macular edema, DME)的临床效果。方法 选取2021年3月—2022年3月在郑州阳城医院门诊治疗的DME患者,经荧光素钠眼底血管造影(FFA)和光学相干断层扫描(OCT)检查确诊48例48眼,随机选24眼为玻璃体腔内注药联合光凝治疗组(简称联合治疗组),另24眼为单纯光凝治疗组(简称单纯组),治疗前两组的最佳矫正视力(BCVA)和中央视网膜厚度(CMT)无显著差异。联合组患者先给予康柏西普玻璃进行体腔内注射药物治疗,在1周后应用技术规范的黄斑区格栅状光凝治疗,单纯组患者仅采用相关黄斑区格栅状光凝治疗,比较治疗前后最佳矫正视力(BCVA)和中央视网膜厚度(CMT)的变化。结果 单纯组与联合组患者的年龄、基线CMT值、基线最佳矫正视力比较,P>0.05,差异无统计学意义。联合组患者治疗1周、治疗1个月、治疗3个月的视力水平高于单纯组,P<0.05,差异有统计学意义。两组患者治疗1天、治疗6个月的视力水平比较,P>0.05,差异无统计学意义。联合组患者治疗1周、治疗1个月、治疗3个月的CMT值低于单纯组,P<0.05,差异有统计学意义。两组患者治疗1天、治疗6个月的CMT值比较,P>0.05,差异无统计学意义。联合组玻璃体腔内注射后眼压升高的发生率4.2%。结论 相比于单纯使用激光进行治疗,康柏西普联合相关黄斑格栅样激光光凝治疗DME患者的近期临床疗效比较显著,能改善黄斑水肿与中心视力,且不良反应较轻,安全性高,患者满意度较高,但其长期疗效和安全性有待于进一步研究。

Objective To observe the efficacy of intravitreal conbercept combined laser photocoagulation for treatment of diabetic macular edema(DME). Methods DME patients treated in outpatient of Zhengzhou Yangcheng Hospital department from March 2021 to March 2022 were selected, 24 eyes were randomly selected for the vitreous cavity injection combined with photocoagulation group and the other 24 eyes were the photocoagulation therapy group(pure group). There was no significant difference between the best-corrected visual acuity(BCVA) and central macular retinal thickness(CMT). Patients in the combination group were treated with intravitreal injection, and the standard photocoagulation in the macular area one week later. Patients in the pure group were treated with only the macular area, comparing the changes of best corrected visual acuity(BCVA) and central macular retinal thickness(CMT) before and after treatment.Results No significant differences were found between age, baseline CMT value, baseline best corrected visual acuity, P>0.05. In the combination group, the vision level of 1 week, 1 month and 3 months after therapy were higher than that of the pure group, P<0.05. There was no significant difference in visual acuity between the two groups, P>0.05. The CMT of the combined group was lower than that of the simple group P<0.05. There was no significant difference in CMT between the two groups P>0.05. The incidence of increased IOP after intravitreal injection of combined group was 4.2%. No complication was observed in two groups during the follow-up duration. Conclusion Compared with laser treatment alone, the recent effect of Compacercept combined with macular grille-like laser photocoagulation in DME patients is significant, which can effectively improve macular edema, improve central vision, with mild adverse reactions, high safety and high patient satisfaction. However, its long-term efficacy and safety need further study.