玻璃体腔内注射康柏西普联合视网膜光凝治疗增生性糖尿病视网膜病变的中长期临床观察

目的:观察玻璃体腔内注射康柏西普联合全视网膜光凝治疗增生性糖尿病视网膜病变的中长期临床效果。方法:收集2014.1~2014.9我院确诊为糖尿病视网膜病变Ⅳ期有少量玻璃体积血光凝困难患者,共12例12只眼。先行玻璃体腔注射康柏西普,再于注射1 w后开始行全视网膜光凝,若合并黄斑水肿联合黄斑格栅样光凝。光凝于1月内完成,术后随访2年。结果:注射康柏西普后,12例患者玻璃体积血吸收,1月内均能完成全视网膜光凝,4例患者联合黄斑格栅样光凝,10例患者术后3月随访时视力有不同程度提高。中长期随访中,4例患者因反复玻璃体出血及增殖加重联合玻璃体切割手术治疗,2例患者因新生血管增生补充光凝,6例患者随访期内病情稳定。结论:玻璃体腔注射康柏西普能促进玻璃体出血吸收,减轻视网膜水肿,使部分光凝困难患者完成光凝,提高视力。中长期随访中,部分患者仍有反复出血及增殖加重,需补充激光或联合手术。

Long-term Clinical Observation of Intravitreal Injection of Conbercept Combined with Pan Retinal Photocoagulation in the Treatment of Patients with Proliferative Diabetic Retinopathy

Objective:To evaluate the long-term clinical effect of intravitreal injection of Conbercept combined with pan retinal photocoagulation (PRP) to treat proliferative diabetic retinopathy.Methods:A retrospective review was performed for eyes diagnosed as phase Ⅳ diabetic retinopathy and mild vitreous hemorrhage (VH) which affecting initial retinal photocoagulation between Jan.2014 to Sep.2014.Twelve eyes (12 patients) were included in the present study.All eyes were intravitreal injected with Conbercept and followed by first retinal photocoagulation one week later.PRP was completed in one month and macular grid photocoagulation was performed if complicated with diabetic macular edema.Results:Vitreous hemorrhage (VH) was absorbed in all eyes after intravitreal injection of Conbercept.PRP was completed in all eyes in one month and four eyes underwent macular grid photocoagulation.Best correct visual acuity (BCVA) in 10 eyes was improvement in 3 months follow-up period.In a long-term follow up,par planavitrectomy (PPV) was performed in 4 eyes with recurrent VH and progressed proliferative retinopathy.Complementary photocoagulation was performed in 2 eyes which complicated with retinal neovascularization.And the rest six eyes need no further intervention during the follow up period.Conclusion:Intravitreal injection of Conbercept could benefit the absorption of VH,alleviate retinal edema,facilitate the completion of PRP,and finally improve BCVA.In the long-term follow up,however,complementary photocoagulation or PPV were required in eyes with recurrent VH and PVR.