康柏西普治疗湿性年龄相关性黄斑变性患者应答反应的临床观察

目的:观察康柏西普治疗湿性年龄相关性黄斑变性(wARMD)患者产生不同应答反应的临床特点及影响因素。方法:回顾性分析2018-01/09于我院行康柏西普玻璃体腔注射(3+PRN)的wARMD患者56例62眼的临床资料。治疗前后均进行最佳矫正视力(BCVA)和光学相干断层扫描(OCT)检查,根据注射3次后1mo BCVA情况评估应答反应并进行分组,BCVA提高≥5个字母者33例35眼纳入有应答组,余23例27眼纳入无应答组,分析两组患者治疗前后BCVA、中心视网膜厚度(CRT)情况及相关资料。结果:注射3次后1mo,有应答组患者BCVA从基线时41.83±7.92个字母提高到52.52±10.61个字母(t=-6.883,P=0.02),无应答组患者BCVA从基线时43.65±10.42个字母提高到44.18±8.47个字母(t=0.471,P=0.684),且治疗后两组患者CRT均较基线有不同程度下降(F=31.47、27.28,均P<0.01)。基线时,有应答组患者中黄斑中心凹下椭圆体带较完整者比例(69%)明显多于无应答组(7%),存在视网膜下液者比例(86%)高于无应答组(44%),存在视网膜内液者比例(31%)低于无应答组(81%)(均P<0.05),但两组患者存在色素上皮脱离者比例无差异(77%vs 59%,P>0.05)。结论:康柏西普可有效减少wARMD患者视网膜下积液和视网膜内积液,不同程度改善患者视力,视网膜外层结构(尤其是椭圆体带)的完整性及存在视网膜下积液的患者治疗后应答反应较好,而存在视网膜内积液患者治疗后应答反应不佳。

Clinical observation of Conbercept in the treatment of patients with wet age-related macular degeneration

·AIM:To observe the clinical characteristics and influence factors of different responses in patients with wet age-related macular degeneration(wARMD)treated with intravitreal conbercept.·METHODS:A total of 62 eyes(56 patients)with wet age-related macular degeneration who received intravitreal Conbercept injections(3+PRN)in our hospital from January to September 2018 were retrospectively analyzed.The best-corrected visual acuity(BCVA)and optical coherence tomography(OCT)were performed before and after treatment.Responses were evaluated and grouped according to BCVA after the last injection.33 cases of 35 eyes with BCVA improvement≥5 letters were included in the response group.23 cases with 27 eyes were included in the non-response group.Before and after treatment,BCVA,central retinal thickness(CRT)and related data of the two groups were analyzed.·RESULTS:One month after 3 injections,BCVA in the response group increased from 41.83±7.92 letters at baseline to 52.52±10.61 letters(t=-6.883,P=0.02),and BCVA increased from 43.65±10.42 letters at baseline to 44.18±8.47 letters in the non-response group(t=0.471,P=0.684).CRT of the two groups after treatment decreased from the baseline(F=31.47,27.28,all P<0.01).Six months after 3 injections,the proportion of patients with the integrity of the macular fovea ellipsoid in response group(69%)was more than that in the non-responsive group(7%),and the proportion of patients with subretinal fluid(86%)was higher than that without SRF in the response group(44%),the proportion of patients with intraretinal fluid(31%)in the response group was lower than that in the non-response group(81%)(all P<0.05),but there was no difference in the proportion of patients with pigment epithelial detachment between the two groups(77%vs 59%,P>0.05).·CONCLUSION:Intravitreal injections of conbercept can effectively reduce the subretinal fluid and retinal fluid in patients with wet age-related macular degeneration,and improve the patient's visual acuity.Patients with the integrity of the outer layer of the retina(especially the ellipsoidal zone)and SRF responded well after treatment,while patients with IRF responded poorly after treatment.