渗出性老年黄斑变性患者玻璃体腔注射康柏西普前后房水中血管内皮生长因子、色素上皮细胞衍生因子浓度的变化

目的 探讨玻璃体腔注射康柏西普治疗对渗出性老年黄斑变性（eAMD）患者的临床疗效及房水中血管内皮生长因子（VEGF）、色素上皮细胞衍生因子（PEDF）水平的变化。方法 选取2013年5月—2017年4月在西电集团医院眼科治疗的eAMD患者75例（75眼）作为研究对象，随机分为治疗组和对照组，分别有38、37例。治疗组患者玻璃体腔注入0.05 mL康柏西普注射液，对照组患者注入0.5 mL曲安奈德注射液，比较两组患者治疗前后最佳矫正视力（BCVA）、黄斑中心凹视网膜厚度（CRT）以及房水中VEGF、PEDF浓度，并观察术后并发症的发生情况。结果 治疗前，两组BCVA、CRT、房水中VEGF、PEDF浓度均无显著差异；术后1、3、6个月治疗组BCVA、CRT均显著高于治疗前，同组治疗前后比较差异有统计学意义（P<0.05），而对照组无显著变化。治疗后治疗组VEGF显著降低、PEDF显著升高，同组治疗前后比较差异有统计学意义（P<0.05），而对照组无显著变化。两组治疗期间不良反应的发生情况比较无显著差异。结论 玻璃体腔注射康柏西普可以显著降低eAMD患者房水中VEGF浓度，提高PEDF水平，改善视力，疗效显著，且无严重的并发症，值得临床应用和推广。

Changes of VEGF and PEDF concentrations in aqueous humor before and after intravitreal injection of Conbercept in patients with eAMD

Objective To explore the clinical efficacy of intravitreal injection of conbercept in the treatment of eAMD and the changes of VEGF and PEDF in aqueous humor. Methods Selected 75 patients (75 eyes) with eAMD in our hospital from May 2013 to April 2017. All patients were randomly divided into treatment group and control group, each group 37, 38 cases. The levels of VEGF and PEDF in aqueous humor, BCVA, CRT were compared before and after treatment, and the occurrence of postoperative complications was observed. Results There was no significant difference in BCVA, CRT and VEGF and PEDF levels before treatment. The levels of BCVA and CRT in the treatment group were significantly higher than those before treatment (P < 0.05), but there was no significant change in the control group. The levels of VEGF were significantly decreased and PEDF was significantly increased in the treatment group after treatment (P < 0.05), but there was no significant change in the control group. There was no significant difference in the incidence of adverse reactions between the two groups. Conclusions Intravitreal injection of Conbercept can significantly reduce the concentration of VEGF in patients with eAMD, improve the level of PEDF. The therapy method can improve vision, significant effect, and no serious complications, worthy of clinical application and promotion.