康柏西普玻璃体内重复注射治疗息肉状脉络膜血管病变疗效及相关因素分析

目的观察康柏西普玻璃体内重复注射治疗息肉状脉络膜血管病变(polypoidal choroidal vasculopathy,PCV)随访24个月的疗效及第13~24个月需要进行重复注射的相关因素。方法回顾性研究。将临床确诊为PCV的35例35眼患者纳入研究,所有患者均行最佳矫正视力(best corrected visual acuity,BCVA)、眼底彩色照相、荧光素眼底血管造影、吲哚菁绿血管造影和光学相干断层扫描(optical coherence tomography,OCT)检查。所有患眼均采用每月注射1次、连续注射3个月后按需治疗的方案行康柏西普玻璃体内注射治疗。随访时间均在24个月以上。治疗后1个月、2个月、3个月、6个月、9个月、12个月、24个月重复行BCVA及OCT检查;治疗后3个月、6个月、9个月、12个月、24个月重复行荧光素眼底血管造影及吲哚菁绿血管造影检查。对比治疗前后BCVA、黄斑中心凹视网膜厚度及浆液性视网膜脱离(serous retinal detachment,SRD)、息肉消退的变化,并分析随访第13~24个月需要进行重复注射的相关因素。结果治疗后1个月、2个月、3个月、6个月、9个月、12个月、24个月患眼BCVA均较治疗前有不同程度提高,差异均有统计学意义(均为P<0.05);黄斑中心凹视网膜厚度较治疗前有不同程度下降,差异均有统计学意义(均为P<0.001)。Logistic回归分析显示,基线视网膜色素上皮脱离是第13~24个月需要进行重复注射的独立相关因素(P=0.042),治疗后6个月、9个月、12个月SRD与第13~24个月需要重复注射相关(P=0.043、0.023、0.012)。结论康柏西普玻璃体内重复注射治疗PCV随访24个月能稳定或提高视力,基线视网膜色素上皮脱离和治疗后6个月、9个月、12个月SRD是第13~24个月需要进行重复注射的相关因素。

Efficacy of intravitreal injection of conbercept in polypoidal choroidal vasculopathy and its related factors

Objective　To observe the efficacy of conbercept in the treatment of polypoidalchoroidalvasculopathy (PCV) patients for 24 months follow-up and to analyze the its related factors of retreatment from 13 months to 24 months.Methods　A retrospective study.Thirty-five eyes of 35 patients with PCV were enrolled into this study.All patients underwent best corrected visual acuity (BCVA),fundus color photography,fundus fluorescein angiography,indocyanine green angiography and optical coherence tomography (OCT).These patients received three initial intravitreal injection of conbercept (IVC) monthly and were retreated with IVC when needed.All patients were followed up for more than 24 months.On 1 month,2,3,6,9,12,and 24 months after treatment,BCVA and OCT examinations were repeated.On 3,6,9,12 and 24 months after treatment,FFA and ICGA examinations were conducted.The changes of BCVA,central retinal thickness (CRT),serous retinal detachment (SRD) and the regression of polyps were observed.The related factors of retreatment from 13 months to 24 months were analyzed.Results　On 1 month,2,3,6,12 and 24 months after treatment,the BCVA improved significantly (all P＜0.05),the CRT were decreased significantly (all P＜0.001).Logistic regression analysis showed the absence of retinal epithelial detachment (RPED) at baseline was a independent factor for requiring retreatment from 13 months to 24 months (P=0.042).SRD at 6 months,9 months,and 12 months after treatment was associated with repeated injections at 13 to 24 months (P=0.043,0.023,0.012).Conclusion　Visual outcomes of PCV patients treated with conbercept improve.RPED at baseline and SRD development during follow-up are related factors for the repeated injections of conbercept from 13 months to 24 months.