频域光学相干断层扫描观察康柏西普治疗老年性黄斑变性患者黄斑结构的变化

目的　利用频域光学相干断层扫描（optical coherence tomography，OCT）观察湿性老年性黄斑变性（age-related macular degeneration，AMD）患者经康柏西普治疗后黄斑中心凹结构的变化并分析与最佳矫正视力（best corrected visual acuity,BCVA）的相关性。方法　经荧光素眼底血管造影确诊为湿性AMD的患者纳入研究，所有患者接受连续3个月、每个月玻璃体内注射一次康柏西普的常规疗法，记录治疗前及各次注射后1个月的BCVA以及频域OCT的特征（黄斑中心凹视网膜厚度、视网膜内积液、视网膜下积液、视网膜色素上皮层脱离、视网膜下纤维化等）。结果　经过3次注射治疗后，BCVA从治疗前的（0.98±0.55）LogMAR提高到治疗后的（0.69±0.43）LogMAR（P<0.01），黄斑中心凹视网膜厚度从治疗前的（449.07±245.19）μm降低到治疗后的（232.76±103.93）μm（P<0.01），其中初次注射后第1个月BCVA和黄斑中心凹视网膜厚度的改善最为明显；3次注射后视网膜内积液或视网膜下积液消退组BCVA改善并没有明显优于各自的未消退组（均为P>0.05），但单纯视网膜下积液组BCVA明显优于单纯视网膜内积液组和混合积液组（F=6.168，P=0.007）。结论　频域OCT是一种评价黄斑结构改变的有效手段，为临床分析注射康柏西普术后视力的变化提供了有力的依据。

Changes in macular structure after treatment with conbercept for age-related macular degeneration by spectral domain optical coherence tomography

Objective　To study the association between visual outcome and changes in foveal structure after treatment with conbercept for wet age-related macular degeneration （AMD） with spectral domain optical coherence tomography （OCT）.Methods　Patients with wet AMD diagnosed by fluorescein fundus angiography were included.All the patients received intravitreal injection of conbercept monthly for 3 months.Best corrected visual acuity （BCVA） and OCT findings ［foveal retinal thickness，intraretinal fluid （IRF），subretinal fluid （SRF），pigment epithelium detachment and subretinal fibrosis］ at baseline and one month after each injection were evaluated.Results　Mean BCVA improved from （0.98±0.55） LogMAR at baseline to （0.69±0.43） LogMAR at the 3rd month （P<0.01）.The mean foveal thickness reduced from （449.07±245.19）μm at baseline to （232.76±103.93）μm at the 3rd month （P<0.01）.The most significant improvement occurred in the first month after treatment.After three injections，patients with or without persisting IRF/ SRF benefitted without statistically significant differences （P>0.05）.The mean BCVA of subretinal fluid group was significantly better than that of intraretinal fluid group and mixed group （F=6.168，P=0.007）.Conclusion　Spectral domain OCT is an effective device for evaluating changes in macular structure.It provides strong evidence for clinical analysis of postoperative visual acuity changes in wet AMD patients receiving intravitreal conbercept treatment.