玻璃体内注射康柏西普对弥漫性糖尿病性黄斑水肿的影响

目的　探讨玻璃体内注射康柏西普对弥漫性糖尿病性黄斑水肿（diabetic macular edema，DME）的影响。方法　选取2016年7月至2017年7月牡丹江医学院红旗医院眼科收治的弥漫性DME患者51例51眼，将患者分为3组，每组各17例17眼:单纯玻璃体内注射康柏西普0.5 mg组（A组）；玻璃体内注射康柏西普0.5 mg联合改良黄斑格栅样光凝组（B组）；单纯改良黄斑格栅样光凝组（C组）。分别于治疗前及治疗后1周、1 个月、3个月和6个月对患者进行光学相干断层扫描检测黄斑中心凹厚度（central macular thickness，CMT）、眼底荧光血管造影（fundus fluorescein angiography，FFA）、最佳矫正视力（best corrected visual acuity，BCVA）、裂隙灯、眼压等检查，比较三种治疗方式的疗效和安全性。结果　三种治疗方式均能改善弥漫性DME患者BCVA、CMT、视网膜新生血管渗漏，但A组、B组疗效均优于C组（均为P＜0.05）。A组、B组患者BCVA改善情况差异无统计学意义（P＞0.05），但B组患者CMT（197.47±45.26）μm及视网膜新生血管渗漏（9.91±3.18）mm²改善情况优于A 组（205.59±47.33）μm、（13.24±4.87）mm²（P＜0.001），且无光凝术及康柏西普相关的并发症发生。结论　改良黄斑格栅样光凝术联合玻璃体内注射康柏西普能迅速减轻弥漫性DME及新生血管形成，从而提高患者视力，其疗效优于单纯改良黄斑格栅样光凝术和单纯康柏西普玻璃体内注射。

Effect of intravitreal injection of conbercept on diabetic diffuse macular edema

Objective　To investigate the effects of intravitreal injection of conbercept on diffuse macular edema (DME) of diabetes mellitus.Methods　Together 51 diabetic patients (51 eyes ) with diffuse macular edema were collected between July 2016 to July 2017，and randomly divided into three groups (n=17):group A，in which patients received solely intravitreal injection of 0.5 mg conbercept，group B，those who was intravitreally injected with 0.5 mg of conbercept and modified macular grating photocoagulation，and group C，patients undergoing modified grid photocoagulation (GPG).Then，before treatment and 1 week，1 month，3 months and 6 months after treatment，all patients were examined by optical coherence tomography for determining central macular thickness (CMT)，followed by fundus fluorescein angiography (FFA)，the best corrected visual acuity (BCVA)，slit lamp，intraocular pressure for compare the efficacy and safety of the three procedures.Results　All the three treatments improved BCVA，CMT，retinal neovascularization (RNV) leakage in diffuse DME patients，but group A and B were better than group C (both P<0.05)，while there was no significant difference in BCVA improvement between A and B group (P>0.05)，whereas the improvement in CMT of group B patients was better than that of group A ［(197.47±45.26)μm vs.(205.59±47.33)μm］ (P<0.001)，and this was true of RNV leakage ［(9.91±3.18)mm vs.(13.24±4.87)mm］ (P<0.001)，without related complications.Conclusion　Combination of modified macular grid photocoagulation and intravitreal injection of conbercept can quickly relieve diabetic macular edema and alleviate neovascularization，thus improving the patients’ vision acuity，of which the efficacy is superior to the pure modified macular grid photocoagulation and conbercept injection.