雷珠单抗与康柏西普联合光动力疗法治疗息肉样脉络膜血管病变的疗效比较

目的:探索玻璃体腔注射雷珠单抗与康柏西普分别联合光动力疗法(PDT)治疗息肉样脉络膜血管病变(PCV)及对视力和血液流变学的影响。方法:前瞻性研究。纳入2017-02/2020-06我院收治的PCV患者120例120眼,根据随机数字表法分为雷珠单抗联合PDT治疗组61例61眼,康柏西普联合PDT治疗组59例59眼,比较两组患者治疗前后眼压、最佳矫正视力(BCVA)、中心视网膜厚度(CRT)、血液流动学,以及随访3mo期间并发症发生率。结果:两组患者治疗前,治疗后1、3mo的眼压、CRT、BCVA比较均无差异(均P>0.05),雷珠单抗联合PDT治疗组治疗后1、3mo的红细胞聚集指数、全血高切黏度、全血低切黏度均低于康柏西普联合PDT治疗组(均P<0.05)。雷珠单抗联合PDT治疗组随访3mo内并发症发生率低于康柏西普联合PDT治疗组(3.3%vs 16.9%,P<0.05)。结论:玻璃体腔注射雷珠单抗联合PDT治疗PCV,更利于血液流变学稳定,降低并发症发生率。

Comparison of Ranibizumab and Conbercept combined with photodynamic therapy in the treatment of polypoid choroidal vascular disease

AIM: To explore the effects of ranibizumab and conbercept combined with photodynamic therapy(PDT)on vision and hemorheology of polypoid choroidal vascular(PCV)lesions.

METHODS: Prospective research. A total of 120(120 eyes)PCV patients who were admitted to our hospital from 2017-02/2020-06 were enrolled and divided into 61 cases(61 eyes)in the ranibizumab combined with PDT treatment group according to the random number table. Conbercept combined with PDT treatment group of 59 patients(59 eyes), compared the intraocular pressure, best corrected visual acuity(BCVA), central retinal thickness(CRT), blood flow, and the incidence of complications within 3mo of follow-up between the two groups before and after treatment.

RESULTS: There was no difference in intraocular pressure, CRT, and BCVA at 1 and 3mo after treatment between the two groups(all P>0.05). The whole blood high shear viscosity and whole blood of the ranibizumab combined with PDT treatment group were 1 and 3mo after treatment. The low-shear viscosity was lower than the conbercept combined with PDT treatment group(all P<0.05). At the same time, the complication rate in the ranibizumab combined with PDT treatment group during the follow-up period of 3mo was lower than that in the conbercept combined with PDT treatment group(3.3% vs 16.9%, P<0.05).

CONCLUSION: The treatment of ranibizumab combined with PDT for patients with PCV disease is more conducive to hemorheological stability and reduces the incidence of complications.