摘要
目的:比较康柏西普3+PRN和3+Q3M注射方案治疗湿性年龄相关性黄斑变性(AMD)的疗效及安全性。方法:前瞻性临床研究。选取2018年8月至2019年8月在山东大学齐鲁医院眼科确诊的湿性AMD患者106例(106眼),所有患眼均可见黄斑区脉络膜新生血管(CNV)渗漏病灶。采用国际标准小数视力表检查最佳矫正视力(BCVA),统计时换算为最小分辨角对数视力(LogMAR),应用光学相干断层扫描(OCT)测量中心视网膜厚度(CRT)。所有患眼玻璃体腔注射康柏西普0.5 mg,其中55只眼每个月注射1针,连续3针后,延长期按需给药(3+PRN);51只眼每个月注射1针,连续3针后,延长期每3个月注射1次(3+Q3M)。开始治疗后第1、2周以及每个月行常规视力、眼压和OCT检查,每3个月行荧光素眼底血管造影检查,观察所有患者治疗前后患眼BCVA、CRT及CNV病灶渗漏面积的变化及术后不良反应。采用重复测量方差分析、卡方检验进行数据比较。结果:治疗1、3、6、9、12个月后,3+PRN组和3+Q3M组患眼平均BCVA均较治疗前改善(3+PRN组:t=7.202、11.178、9.914、9.869、10.587,均P<0.001;3+Q3M组:t=5.548、9.780、9.358、11.884、11.622,均P<0.001),平均CRT均较治疗前降低(3+PRN组:t=12.28、17.041、17.615、15.739、16.171,均P<0.001;3+Q3M组:t=10.221、15.598、16.297、16.984、17.275,均P<0.001),差异均有统计学意义。其中治疗9、12个月后3+Q3M组患眼BCVA明显高于3+PRN组,差异有统计学意义(t=2.304,P=0.023;t=2.058,P=0.042);治疗9、12个月后3+Q3M组患眼平均CRT明显低于3+PRN组,差异有统计学意义(t=2.032,P=0.045;t=2.092,P=0.039)。治疗12个月时,FFA、ICGA检查发现3+PRN组31眼(56%)、3+Q3M组32眼(63%)渗漏完全消失,3+PRN组18眼(33%)、3+Q3M组15眼(29%)渗漏减轻,3+PRN组6眼(11%)、3+Q3M组4眼(8%)渗漏面积不变或扩大,2组比较差异无统计学意义。随访期间均未见与治疗相关的严重眼部并发症及全身严重不良反应发生。结论:康柏西普3+PRN�
Objective:To assess the clinical effectiveness of an intravitreal injection of conbercept using two different strategies,the 3+PRN and 3+Q3M strategies,for the treatment of wet age-related macular degeneration(AMD).Methods:Prospective clinical study.Patients at Qilu Hospital,Shandong University who were confirmed to have exudative AMD from August 2018 to August 2019 were included.Exudative lesions of choroidal neovascularization(CNV)in the macular area were found in all 106 eyes of these patients.The international standard decimal visual acuity chart was used to measure best corrected visual acuity(BCVA).This was converted to the logarithm of the minimum angle of resolution(LogMAR)for the analysis.Optical coherence tomography(OCT)was used to measure central retinal thickness(CRT).For all eyes,an intravitreal injection of 0.5 mg of conbercept was administered with one of two strategies:55 eyes received once monthly injections for the first 3 months,then 3+prore nata(3+PRN),and 51 eyes received once monthly injections for the first 3 months,followed by one injection every 3 months(3+Q3M).The patients were followed up for 12 months after the treatment.Routine examinations of BCVA,intraocular pressure(IOP),and OCT were conducted at 1 and 2 weeks after the operation,then these examinations were conducted every month.FFA examination was conducted every 3 months after the operation.The changes in BCVA,CRT and exudation of CNV lesions of the eyes were measured before and after treatment.Repeated measures analysis of variance was used to compare the groups and show the time effect,while the LSD t-test was used for comparisons among different time points within the same group.Results:The mean BCVA in both groups improved significantly at 1,3,6,9 and 12 months after the operation,compared to the levels before treatment(3+PRN:t=7.202,11.178,9.914,9.869,10.587,respectively,P<0.001;3+Q3M:t=5.548,9.780,9.358,11.884,11.622,respectively,P<0.001).In addition,the BCVA of the eyes was also significantly better in the 3+Q3M group tha
作者
张鹏
高蕾
王淑静
李一啸
王红
Peng Zhang;Lei Gao;Shujing Wang;Yixiao Li;Hong Wang(Department of Ophthalmology,Jinan 2nd People's Hospital,Jinan 250001,China;Guangming Ophthalmic Hospital,Liaocheng 252000,China;Jining Medical University,Jining 272000,China;Department of Ophthalmology,Qilu Hospital,Shandong University,Jinan 250012,China)
出处
《中华眼视光学与视觉科学杂志》
CAS
CSCD
2021年第4期260-266,共7页
Chinese Journal Of Optometry Ophthalmology And Visual Science
