玻璃体内注射康柏西普治疗缺血型和非缺血型视网膜中央静脉阻塞继发黄斑囊样水肿的疗效对比

Therapeutic effects of intravitreal injection of Conbercept in treatment of cystoid macular edema secondary to ischemic and non-ischemic CRVO

摘要:

目的 对比玻璃体内注射康柏西普（IVC）治疗缺血型视网膜中央静脉阻塞继发黄斑囊样水肿（I-CRVO-CME）和非缺血型视网膜中央静脉阻塞继发黄斑囊样水肿（NI-CRVO-CME）的临床疗效。方法 回顾性分析2016年1月—2020年1月庆阳市人民医院收治的49例I-CRVO-CME（I-CRVO-CME组）和54例NI-CRVO-CME（NI-CRVO-CME组）患者的临床资料。两组均采用IVC治疗，治疗3个月后继续随访12个月。比较两组随访期间治疗次数；比较治疗后3个月、6个月、9个月、12个月两组最佳矫正视力（BCVA）字母增加数、黄斑中心凹视网膜厚度（CRT）减少量、黄斑区水肿容积（MEV）缩小量；比较两组不良反应。结果 与I-CRVO-CME组比较，NI-CRVO-CME组IVC与曲安奈德联用次数、IVC与激光联用次数减少（P <0.05）。NI-CRVO-CME组与I-CRVO-CME组治疗后3个月、6个月、9个月、12个月BCVA字母增加数、CRT减少量、MEV缩小量比较，采用重复测量设计的方差分析，结果 ①不同时间点间BCVA字母增加数、CRT减少量、MEV缩小量有差异（P <0.05）；②两组BCVA字母增加数、CRT减少量、MEV缩小量有差异（P <0.05），NI-CRVO-CME组较高，相对视力、黄斑区水肿改善效果较好；③两组BCVA字母增加数、CRT减少量、MEV缩小量变化趋势有差异（P <0.05）。两组不良反应发生率比较，差异无统计学意义（P >0.05）。结论 IVC治疗I-CRVO-CME和NI-CRVO-CME均可提高患者视力，消退CME，但对NI-CRVO-CME的治疗效果更好。

关键词:视网膜中央静脉阻塞;黄斑囊样水肿;缺血型;非缺血型;康柏西普

Abstract:

Objective To compare the effects of intravitreal injection of Conbercept (IVC) on cystoid macular edema secondary to ischemic central retinal vein occlusion (I-CRVO-CME) and non-ischemic CRVO-CME (NI-CRVO-CME).Methods The clinical data of 49 patients with I-CRVO-CME and 54 patients with NI-CRVO-CME in our hospital from January 2016 to January 2020 were retrospectively analyzed. They were assigned to the I-CRVO-CME group and NI-CRVO -CME group. Both groups were treated with IVC and followed up for 12 months after 3 months of treatment. The number of treatments between the two groups were compared. The increase in the number of letters of the best corrected visual acuity (BCVA), the decrease in the macular foveal retinal thickness (CRT), and the decrease in the volume of macular edema (MEV) in the two groups at 3, 6, 9, and 12 months after treatment were compared.Results Compared with the I-CRVO-CME group, the frequency of IVC combined with triamcinolone and IVC combined with laser in the NI-CRVO-CME group were decreased (P < 0.05). BCVA letters increase and CRT reduction were compared between NI-CRVO-CME group and I-CRVO-CME group at 3, 6, 9, and 12 months after treatment, with repeated measures analysis of variance. The results showed: (1) There were differences in the BCVA letter increase, CRT reduction, and MEV reduction between different time points (P < 0.05); (2) There were differences in the BCVA letter increase, CRT reduction, and MEV reduction between the NI-CRVO-CME group and the I-CRVO-CME group (P < 0.05). Compared with the I-CRVO-CME group, the BCVA letter increase, CRT reduction, and MEV reduction were increased in the NI-CRVO-CME group, in which the relative vision and macular edema. (3) The BCVA letter increase, CRT reduction, and MEV reduction between the NI-CRVO-CME group and the I-CRVO-CME group had different trends (P < 0.05). There was no significant difference in the incidence of adverse reactions between the I-CRVO-CME group and the NI-CRVO-CME group (P > 0.05).Conclusion IVC can improve patients' vision and resolve CME in the treatment of I-CRVO-CME and NI-CRVO-CME, but the effect of treatment of NI-CRVO-CME is better than that of I-CRVO-CME.

Key words:central retinal vein occlusion;macular edema;ischemic type;non-ischemic type;Conbercept