玻璃体腔注射康柏西普联合激光治疗视网膜静脉阻塞黄斑水肿的长期疗效

doi:10.3760/cma.j.cn115909-20191226-00350

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Abstract Objective: To study the long-term effect of intravitreal injection of conbercept combined with photocoagulation in the treatment of macular edema due to retinal vein occlusion. Methods: This was a retrospective study. Eighty-one patients (81 eyes) with macular edema (ME) due to RVO (retinal vein occlusion) were included in the study from January 31, 2016 to January 30, 2017. All patients were followed up until July 31, 2019. There was no recurrence of ME 6 months after CMT (central macular thickness) stabilized. Of the 81 eyes treated by intravitreal injection of conbercept combined with photocoagulation, 48 patients (48 eyes) finished the treatment. The longest follow-up time was 30 months. Before and after treatment, a paired sample t test was used for comparison, and a chi-square test was used for rate comparison. Results: Among the 81 eyes included in the study, central retinal vein occlusion (CRVO) was seen in 15 eyes, branch retinal vein occlusion (BRVO) was seen in 66 eyes, and most patients had underlying diseases. Forty-eight patients completed the treatment to the end point and were examined at 1 week and 1, 2, 3, 6, 9, 12, 15, 18, 21, 24, and 30 months after treatment. The logMAR best corrected visual acuity (BCVA) was 0.3±0.25 before treatment, and BCVA was significantly higher after intravitreal injection of conbercept combined with timely photocoagulation treatment than BCVA prior to treatment. The difference between CMT after treatment and the average CMT before treatment (607±158 μm) was statistically significant (P<0.05). The average follow-up time for the 48 patients was 15.4±5.3 months, and the average number of injections was 4.4±1.3. The average time from the beginning of photocoagulation treatment to the first vitreous injection was 4.3±3.5 months in 48 eyes. The average time to complete the treatment was 12.8±1.3 months in the group with a photocoagulation start time ≤3 months, and the average number of intravitreal injections was 4.3±0.8; the average time to complete the treatment was 18.0±6.6 months in the group with a photocoagulation start time >3 months and 5.4±1.5 times in the group with vitreous injections. There was a significant difference between the two groups (early or late start times) (t=-2.4, P=0.04) in the amount of time for completing treatment, and there was a significant difference between the two groups in the number of intravitreal injections (t=-2.3, P=0.04). Conclusions: The effect of intravitreal injection of conbercept combined with timely laser in the treatment of RVO-induced ME is significant. When laser treatment is performed earlier on patients who need photocoagulation treatment, it can result in a significant reduction in treatment time and number of injections, and the visual function of patients can be preserved.

Key words： retinal vein occlusion macular edema angiogenesis inhibitors optical coherence tomography

Received: 26 December 2019

Corresponding Authors: Gaiping Du, Department of Ophthalmology, No. 971 Hospital of the Chinese PLA Navy, Qingdao 266000, China (Email: glaucoma@163.com)

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