康柏西普及光凝治疗弥漫型糖尿病性黄斑水肿的效果

目的:比较单纯康柏西普玻璃体内注射、单纯黄斑格栅激光光凝及二者联合治疗对弥漫型糖尿病性黄斑水肿(DME)的效果。方法:回顾性研究。将2016年8月至2019年10月长治医学院附属和平医院弥漫型DME 74例(82眼)分为单纯康柏西普玻璃体内注射组(A组,31眼)、单纯黄斑格栅激光光凝组(B组,24眼)和康柏西普联合激光光凝组(C组,27眼)。治疗后随访6个月,观察比较治疗前后视力、黄斑中心区厚度、FFA及注射次数。结果:治疗后A组和C组BCVA及黄斑中心区厚度(CMT)均较治疗前改善(P<0.05);B组治疗后BCVA无改善;B组CMT治疗后1个月无改善,治疗后3及6个月CMT下降(P<0.05)。治疗后BCVA及CMT的改善程度A组和C组差异无统计学意义,但均优于B组(P<0.05)。治疗后6个月FFA改善率3组间差异无统计学意义。治疗后6个月内康柏西普平均注射次数C组少于A组(P=0.001)。结论:康柏西普玻璃体内注射联合黄斑格栅激光光凝与单纯康柏西普注射治疗弥漫型DME效果相近,均优于单纯黄斑格栅激光光凝;黄斑格栅激光光凝可减少康柏西普注射次数。

Clinical efficacy of intravitreal conbercept injection and photocoagulation for the treatment of diffuse diabetic macular edema

Objective To compare the efficacy among three methods of intravitreal conbercept(IVC)injection monotherapy,macular laser grid photocoagulation(MLG)monotherapy and IVC combined with MLG for the treatment of diffuse diabetic macular edema(DDME).Methods This is a retrospective study.Total of 82 eyes of 74 patients with DDME in Heping Hospital Affiliated to Changzhi Medical College from Aug.2016 to Oct.2019 were collected.All patients were divided into 3 groups,31 eyes received IVC monotherapy as group A,24 eyes received MLG monotherapy as group B and 27 eyes received IVC combined with MLG as group C.The followed up time was 6 months.The best corrected visual acuity(BCVA),the central macular thickness(CMT),the results of fundus fluorescence angiography(FFA)and number of times of injection were observed and compared.Results The BCVA were improved and the CMT were reduced statistically in group A and group C after operation(P<0.05).The BCVA after operation were not improved in group B.The CMT in group B at 3 and 6 months postoperatively were reduced(P<0.05),but the CMT was unchanged at 1 month postoperatively.There was no statistically significant difference in improvement of BCVA and reduction of CMT between group A and group C at each time points during follow-up.BCVA improvement and CMT reduction in group A and group C were more than those in group B at each time points during follow-up(P<0.05).The difference in improvement rate of FFA was not statistically significant among the three groups at 6 months postoperatively.The number of times of injections in the group C was less than that in the group A(P=0.001).Conclusion The efficacy of IVC monotherapy and IVC combined with MLG for the treatment of DDME are similar,which are more effective than MLG monotherapy.In addition,MLG can help to reduce the number of IVC.