糖尿病黄斑水肿玻璃体内注射康柏西普的短期疗效和椭圆体带完整性改变的观察

摘要

Objective To evaluate the efficacy and safety of intravitreal injection of conbercept for diabetic macular edema (DME) and the changes of ellipsoid zone (EZ).Methods A retrospective study was conducted in 14 patients (16 eyes) and the clinical data were reviewed and analyzed.All the patients were administrated with conbercept intravitreally,and rechecked 1 month,2 months,3 months after injection including the best corrected visual acuity (BCVA) and optical coherence tomography (OCT).Then a comparison was performed in logMAR BCVA,central foveal thickness (CFT) and macular volume before treatment and 1 month,2 months and 3 months after conbercept injection,as well as the cross-sectional length of incomplete portion in EZ before treatment and 3 months after injection.Results The value of logMAR BCVA before treatment and 1 month,2 months and 3 months after conbercept injection was 0.79 ± 0.08,0.65 ± 0.07,0.56 ± 0.06 and 0.52 ± 0.06,respectively;the average CFT before treatment and 1 month,2 months and 3 months after treatment was (536.44 ±35.87) μm,(385.63 ± 22.60) μm,(336.13 ± 21.91) μm and (292.38 ± 22.54) μm accordingly;the macular volume before treatment and 1 month,2 months and 3 months after treatment was (11.27 ± 0.37) mm3,(10.21 ± 0.22) mm3,(9.69 ± 0.17) mm3 and (9.30 ±0.20) mm3,respectively,with statistically significance in palrwise comparison.Moreover,the cross-sectional length of disrupted EZ before treatment and 3 months after injection was (3116.69 ± 385.55) μm and (1784.88 ± 362.39) μm respectively,and there was statistically significant difference (P ＜ 0.05).Conclusion Intravitreal injection of conbercept to treat DME can alleviate macular edema and restore the disrupted ellipsoid zone.%目的 评估糖尿病黄斑水肿(diabetic macular edema,DME)患者玻璃体内注射康柏西普的短期疗效并观察椭圆体带(ellipsoid zone,EZ)完整性改变情况.方法 DME患者14例(16眼),所有患眼均行玻璃体内注射康柏西普治疗.在注射后1个月、2个月、3个月时分别复查最佳矫正视力(best corrected visual acuity,BCVA)、光学相干断层扫描(optical coherence tomography,OCT).比较注射前与注射后1个月、2个月、3个月的logMAR BCVA、黄斑体积和黄斑中心凹视网膜厚度(central foveal thickness,CFT)以及注射前与注射后3个月的中心凹EZ不完整部分的横断面长度.结果 患眼注射前logMAR BCVA为0.79±0.08,CFT为(536.44±35.87) μm,黄斑体积为(11.27±0.37) mm3.注射后1个月患眼logMAR BCVA为(0.65±0.07),CFT为(385.63±22.60) μm,黄斑体积为(10.21 ±0.22) mm3.注射后2个月患眼logMAR BCVA为0.56±0.06,CFT为(336.13±21.91)μm,黄斑体积为(9.69±0.17) mm3.注射后3个月患眼logMAR BCVA为0.52±0.06,CFT为(292.38±22.54) μm,黄斑体积为(9.30±0.20) mm3.两两比较差异均有统计学意义(均为P＜0.05).所有患者注射前通过黄斑中心凹的EZ不完整部分的横断面长度为(3116.69 ±385.55) μm,3次注射后为(1784.88±362.39) μm,差异有统计学意义(P＜0.05).结论 玻璃体内注射康柏西普可以减轻黄斑水肿,提高患者视力,改善黄斑区椭圆体带完整性.