单次注射康柏西普治疗渗出型AMD患者RPE隆起面积与容积变化

目的　观察单次玻璃体内注射康柏西普治疗渗出型年龄相关性黄斑变性（ａｇｅ-ｒｅｌａｔｅｄｍａｃｕｌａｒｄｅｇｅｎｅｒａｔｉｏｎ，ＡＭＤ）患者的视网膜色素上皮（ｒｅｔｉｎａｌｐｉｇｍｅｎｔｅｐｉｔｈｅｌｉｕｍ，ＲＰＥ）隆起的面积及容积变化，以评价康柏西普治疗ＡＭＤ的短期疗效及安全性。方法　选取渗出型ＡＭＤ患者４０例（４５眼），所有患者均行玻璃体内注射康柏西普０．０５ｍＬ（０．５ｍｇ）治疗。术前、术后１周、１个月及３个月复诊行Ｃｉｒｒｕｓ５０００ＯＣＴ检查，比较治疗前后最佳矫正视力（ｂｅｓｔｃｏｒｒｅｃｔｅｄｖｉｓｕａｌａｃｕｉｔｙ，ＢＶＣＡ）、黄斑中心凹厚度及ＲＰＥ隆起的面积、容积。结果　术后１周、１个月，ＢＣＶＡ（ｌｏｇＭＡＲ）由术前１．２５±０．７９分别提升至０．９２±０．６６（Ｐ＜０．００１）和０．９４±０．６１（Ｐ＜０．００１），３ｍｍ圆内ＲＰＥ隆起面积及容积由术前的（２．９１±１．７３）ｍｍ２、（０．５０±０．７３）ｍｍ３分别降至（２．７５±１．８２）ｍｍ２（Ｐ＝０．０２４）、（０．４２±０．７１）ｍｍ３（Ｐ＝０．０２０）和（２．３３±１．８５）ｍｍ２（Ｐ＝０．００２）、（０．３２±０．０９）ｍｍ３（Ｐ＝０．０４６）。术后３个月时ＢＣＶＡ下降至１．３０±０．８２，与术前差异无统计学意义（Ｐ＞０．０５）；３ｍｍ圆内ＲＰＥ隆起面积及容积增加到（２．７３±１．８１）ｍｍ２、（０．５１±０．７９）ｍｍ３，与术前相比差异均无统计学意义（均为Ｐ＞０．０５）。术后１周、１个月、３个月５ｍｍ圆内ＲＰＥ隆起面积及容积与术前差异均无统计学意义（均为Ｐ＞０．０５）。黄斑中心凹厚度仅在术后１个月由术前（２４４．５６±２５．３７）μｍ降至（２３４．９１±２１．５０）μｍ（Ｐ＝０．０４４）。所有患者均未出现严重眼部并发症及全身不良反应。结论　康柏西普短期内治疗渗出型ＡＭＤ可显著提高视力，恢复视网膜结构，具有良好的安全性。

Changes of retinal pigment epithelium uplift area and volume in exudative age-related macular degeneration after once injection of conbercept

Objective To evaluate the changes of retinal pigment epithelium (RPE) uplift area and volume in exudative age-related macular degeneration ( AMD) after once injection of conbercept, and evaluate the short-term efficacy and safety of conbercept for AMD. Methods Forty patients (45 eyes) with exudative AMD were chosen , and all cases adopt conbercept injection (0. 5 mL ,0. 5 mg) . The changes of central macular retinal thickness ( CMT) and RPE uplift in area and volume at the preoperation and postoperative I week, I month and 3 months were detected by Cirrus 5000 OCT , and the best corrected visual acuity ( BCVA) was also examined. Results At I week and I month after treatment , BCVA was improved from l. 25 +0. 79 preoperatively t0 0. 92 + 0. 66 .0. 94 +0. 61 ( all P < 0. 001) ; Within 3 mm in circle RPE uplift in area and volume were respectively dropped from (2. 91 + 1. 73 ) mm2 . (0. 50 + 0. 73 ) mm3 to (2. 75 + 1. 82) mm’ (P = 0. 024) . ( 0. 42 + 0. 71 ) mm3 (P = 0. 020 ) and ( 2. 33 + 1. 85 ) mm2 (P = 0. 002) . ( 0. 32 + 0. 09 ) mmJ ( P = 0. 046 ) . At 3 months after treatment , BCVA was dropped t0 1. 30 +0. 82; Within 3 mm in circle RPE uplift area and volume were improved to ( 2. 73 + 1. 81 ) mm2 . ( 0. 51 + 0. 79 ) mmJ , there was no statistically sigruficant difference compared with pre-operation ( all P > 0. 05 ) . There was no statistically significant difference in within 5 mm in circle RPE uplift area and volume compared with preoperation ( all P > 0. 05 ) . CMT was dropped from ( 244. 56 + 25 . 37 ) Vm preoperatively to ( 234. 91 + 21. 50) Vm at I month after treatment ( P = 0. 044 ) . Severe ocular complication and systenuc adverse reaction has not been found. Conclusion Conbercept can improve BCVA sigruficantly and restore the structure of retina with good security for AMD in short-term.