摘要
目的:探讨玻璃体腔内注射康柏西普(IVC)联合全视网膜光凝(PRP)治疗合并黄斑水肿(DME)的重度非增殖性糖尿病性视网膜病变(SNPDR)患者的给药时机。方法:前瞻性病例对照研究。选取2017-05/2018-10于我院确诊的合并DME的SNPDR患者85例85眼,随机分为三组:对照组29眼仅予以PRP治疗;IVC组28眼在IVC后1wk予以PRP;PRP组28眼在PRP后1wk予以IVC。随访12mo,观察治疗前及治疗后1、3、6、12mo最佳矫正视力(BCVA)、黄斑区中心凹厚度(CMT)变化,记录IVC频次。结果:三组患者治疗后的BCVA较治疗前改善,CMT较治疗前降低(P<0.05)。治疗后IVC组和PRP组BCVA优于对照组,CMT低于对照组(P<0.05)。治疗后3mo,ICV组BCVA(0.24±0.18,LogMAR)下降均较PRP组(0.38±0.29,LogMAR)明显(P<0.05)。治疗后1、3mo,ICV组CMT(313.89±61.69、287.64±43.94μm)下降均较PRP组(347.50±56.55、318.04±49.33μm)明显(P<0.05)。IVC给药频次为IVC组3.07±1.33次、PRP组3.93±1.60次(P<0.05)。结论:治疗合并DME的SNPDR患者,IVC联合PRP治疗优于单纯PRP治疗,且在PRP治疗之前予以抗VEGF药物,短期内BCVA提高、黄斑水肿减轻,长期观察可减少IVC次数,降低感染风险,减轻经济负担。
AIM:To investigate the timing of using anti-VEGF drugs in severe non-proliferative diabetic retinopathy(SNPDR)patients with diabetic macular edema(DME)treated with intravitreal injection of Conbercept(IVC)combined with panretinal photocoagulation(PRP).METHODS:Totally 85 SNPDR patients(85 eyes)with DME diagnosed in our hospital from May 2017 to October 2018 were randomly divided into control group(n=29 cases),IVC group(n=28 cases),PRP group(n=28 cases).The control group was treated with PRP only;the IVC group was given PRP 1wk after IVC;the PRP group was given IVC 1wk after PRP.The follow-up time was 12mo.Changes of the best corrected visual acuity(BCVA)and central macular thickness(CMT)were observed before and 1,3,6,12mo after treatment,and the frequency of IVC were recorded.RESULTS:Compared with before treatment,the BCVA of the three groups after treatment improved,and the CMT decreased(P<0.05).after treatment,the BCVA of the IVC group and the PRP group was better than the control group,and the CMT was lower than the control group(P<0.05).3mo after treatment,BCVA(0.24±0.18,LogMAR)in the ICV group decreased more than that in the PRP group(0.38±0.29,LogMAR)(P<0.05).At 1 and 3mo after treatment,CMT in the ICV group(1mo 313.89±61.69um,3mo 287.64±43.94μm)decreased more than that in the PRP group(1mo 347.50±56.55μm,3mo 318.04±49.334μm),and the difference was significant difference(P<0.05).The frequency of IVC was(3.07±1.33)times in the IVC group and(3.93±1.60)times in the PRP group(P<0.05).CONCLUSION:In SNPDR patients with DME,IVC combined with PRP is better than PRP alone.Anti-VEGF drugs before PRP can obtain better BCVA,reduce macular edema in the short-term observation.In long-term observation,it can also reduce the frequency of IVC,the risk of infection and the financial burden.
作者
张燕
冯劼
李培凤
金翼
肖泽锋
Yan Zhang;Jie Feng;Pei-Feng Li;Yi Jin;Ze-Feng Xiao(Department of Ophthalmology, the First Hospital of Wuhan, Wuhan 430022, Hubei Province, China)
出处
《国际眼科杂志》
CAS
北大核心
2020年第11期1950-1954,共5页
International Eye Science
基金
武汉市卫生计生委科研基金资助项目(No.WX17C01)。
