玻璃体内注射康柏西普治疗湿性年龄相关性黄斑变性的临床观察

摘要

目的 观察玻璃体内注射康柏西普治疗湿性年龄相关性黄斑变性(age-related macular degeneration,AMD)的临床疗效及安全性.方法 回顾性临床研究.选择2014年3月至2016年3月在我院确诊为湿性AMD患者60例(60眼),给予玻璃体内注射康柏西普0.5 mg,随访6～12(8.5±2.4)个月.对比分析患者注射前和注射后1、2、3、6个月及末次随访的ETDRS视力、黄斑中心凹视网膜厚度(central macular thickness,CMT)及脉络膜新生血管(choroidal neovascularization,CNV)病灶渗漏变化情况.结果 康柏西普注射次数为1 ～5(2.80±0.89)次.首次注射后1、2、3、6个月及末次随访时,ETDRS视力较治疗前分别提高(14.76±5.89)、(19.88±7.13)、(24.75±6.74)、(23.94±6.15)、(22.89±8.53)个字母,差异均有统计学意义(均为P＜0.05);CMT较治疗前分别降低(70.19±60.56) μm、(82.07±57.97) μm、(95.40±87.92)μm、(97.57±46.68) μm、(107.46±56.82) μm,差异均有统计学意义(均为P＜0.05).首次注射前CNV渗漏面积为(12.32±5.67) mm2,与首次注射后3、6个月的CNV渗漏面积比较,差异有统计学意义(均为P＜0.05).注射后仅有4例出现球结膜下点片状出血,3例患者出现轻度眼压升高,均在治疗后1周复查恢复正常.随访期间未见眼部及全身严重不良反应发生.结论 玻璃体内注射康柏西普治疗湿性AMD可提高患眼视力,降低CMT,封闭CNV渗漏,无与治疗相关的严重副反应发生.%Objective To observe the efficacy and safety of intravitreal injection of conbercept for wet age-related macular degeneration.Methods Retrospective clinical study.Sixty eyes of 60 cases diagnosed as wet age-related macular degeneration (AMD) definitely were intravitreally injected conbercept 0.5 mg from March 2014 to March 2016.Follow-up time was 6 months to 12 months,averaged (8.5 ± 2.4) months.Visual acuity (ETDRS charts letter),central macular thickness (CMT),leakage of choroidal neovasculaxization (CNV) and area of CNV and complications before and after the treatment were analyzed.Results Conbercept injection therapeutic times were 1-5,the average therapeutic times were 2.80 ± 0.89.At 1 month,2 months,3 months and 6 months after treatment and the last follow up,the mean letter of ETDRS charts increased (14.76 ± 5.89) letters,(19.88 ± 7.13) letters,(24.75 ± 6.74) letters,(23.94 ±6.15) letters,(22.89 ± 8.53) letters compared with pre-operation,respectively (all P ＜0.05).CMT decreased (70.19 ± 60.56) μm,(82.07 ± 57.97) μm,(95.40 ± 87.92) μm,(97.57 ± 46.68) μm,(107.46 ± 56.82) μm compared with pre-operation,respectively (all P ＜ 0.05).Before treatment,the area of CNV leakage was (12.32 ± 5.67) mm2,and at postoperative 3 months,6months the area were statistically significant different (all P ＜ 0.05).Four cases had subconjunctival flake bleeding,intraocular pressure increased slightly in 3 cases and they all recovered at 1 week after treatment.There was no serious ocular and system complication.Conclusion Intravitreal injection of conbercept for wet AMD can improve the visual acuity,decrease CMT and inhibit the CNV regression without serious complication.