玻璃体腔注射康柏西普治疗葡萄膜炎继发黄斑水肿疗效观察

摘要

目的:评估玻璃体腔注射康柏西普治疗葡萄膜炎继发黄斑水肿的临床疗效.方法:选取2013年7月至2015年9月我院门诊收治的24例33眼葡萄膜炎继发黄斑水肿患者作为研究对象,依据治疗方法分为两组:玻璃体腔注射康柏西普治疗组(康柏西普组,n=12,17眼)和玻璃体腔注射曲安奈德治疗组(曲安奈德组,n=12,16眼).采用最佳矫正视力(BCVA)、荧光素眼底血管造影术(FFA)、光学相干断层扫描技术/光学相干层析成像(OCT)及中央视网膜厚度(CRT)评估治疗6个月后药物临床疗效.结果:治疗前两组患者BCVA、OCT之间的差异均无统计学意义(P>0.05),治疗后6个月与曲安奈德组相比,康柏西普组患者的BCVA显著较高,差异有统计学意义(P<0.05),OCT显著较低,差异有统计学意义(P<0.05);和治疗前相比,治疗后6个月两组患者BCVA显著较高,差异有统计学意义(P<0.05),OCT显著较低,差异有统计学意义(P<0.05).FFA检查:治疗的24例33眼中,均未发现新的出血部位,也没有新的血管形成;其中13例患者19只患眼黄斑部渗漏病变,相较治疗前范围减小,另外11例14眼黄斑部已观察不到病变.康柏西普组患者治疗的总有效率94.1%(16/17)显著高于曲安奈德组75.0%(12/16),差异有统计学意义(P<0.05).曲安奈德组并发症发生率为35.3%,康柏西普组并发症发生率为25.0%,两组患者并发症发生率之间的差异无统计学意义(P>0.05).结论:玻璃体腔注射康柏西普能有效治疗葡萄膜炎继发黄斑水肿,治疗后患者视力稳定.%To determine the therapeutic effect of intravitreal injection of conbercept ophthalmic injection(conbercept)for the treatment of uveitic cystoid macular edema.Methods:24 patients of 33 eyes with uveitic cystoid macular edema treated by intravitreal injection of conbercept during July 2013 to September 2015 were divided into two groups: intravitreal injection of conbercept ophthalmic injection treatment group(conbercept,n=12,17 eyes)and intravitreal injection of triamcinolone acetonide injection treatment group(tri-amcinolone acetonide group,n=12,16 eyes)according to the treatment methods.The best corrected visual acuity(BCVA),fluorescein fun-dusangiography(FFA),optical coherence tomography(OCT)and central retinal thickness(CRT)were observed on the therapeutic effect of drug after 6 months.Results:Before treatment,the differences of BCVA and OCT between the two groups of patients were not statistical significant(P>0.05).Compared with the triamcinolone acetonide group,the BCVA of the conbercept group after 6 months treatment was significantly higher,there was statistical significance(P<0.05),the OCT was significantly lower,there was statistical significance(P<0.05).Compared with before treatment,the BCVA after 6 months treatment of the two groups of patients was significantly higher, there was statistical significance(P<0.05),the OCT was significantly lower, there was statistical significance(P<0.05).FFA examination:no new bleeding site were found in 33 eyes of 24 cases,and no new blood vessels were formed.Of them,13 cases of patients had 19 eyes with macular leakage.Compared with before treatment,the range of them decreased,and 11 cases of 14 eyes were not observed in macu-lar.The total effective rate 94.1%(16/17)of the compaitcept group was significantly higher than the triamcinolone acetonide group 75.0%(12/16),there was statistical significance(P<0.05).The incidence of complication rate of triamcinolone acetonide group was 35.3%,the incidence of complication of the conbercept group was 25.0%,the difference between two groups was not statistical signifi-cant(P>0.05).Conclusion:Intravitreal injection of conbercept can be effective in the treatment of uveitic cystoid macular edema and pa -tients with stable vision after injection.