康柏西普联合黄斑格栅光凝治疗糖尿病性黄斑水肿的疗效

目的　应用光学相干断层扫描血管造影（OCTA）与多焦视网膜电图（mf-ERG）评估康柏西普联合黄斑格栅光凝对糖尿病性黄斑水肿（diabetic macular edema，DME）患者黄斑水肿及视力的改善作用，并分析作用机制。方法　选择我院2017年4月至2018年7月DME患者80例，随机分为对照组（40例）和试验组（40例），对照组只进行格栅光凝治疗，试验组同时给予康柏西普眼内给药治疗，分别于治疗前及治疗后1个月、3个月、6个月应用OCTA与mf-ERG检测黄斑及视网膜功能和视力状况，并应用OCT和FFA检测黄斑中心凹厚度及荧光素渗漏状况。结果　两组治疗前与治疗1个月、3个月、6个月后黄斑中心凹无血管区（FAZ）和黄斑区视网膜血管密度比较以及对照组治疗前视力与治疗后比较，差异均无统计学意义（均为P>0.05）；试验组治疗后3个月和6个月时的视力均高于治疗前与同期的对照组，差异均有统计学意义（均为P<0.05）；试验组治疗后3个月、6个月时，mf-ERG的P₁、N₁波环1、环4反应密度均高于同期对照组，差异均有统计学意义(均为P<0.05)。两组治疗后1个月、3个月、6个月的OCT和FFA结果均优于治疗前，治疗后6个月时的各项指标结果均优于治疗后1个月、3个月，差异均有统计学意义(均为P<0.05)。两组患者间治疗后1个月、3个月、6个月OCT和FFA结果比较，差异均无统计学意义（均为P>0.05）。结论　在黄斑格栅光凝基础上，联合康柏西普眼内注药治疗DME患者，能够显著改善患者黄斑、视网膜结构和功能，提高患者视力水平。

The effect of conbercept combined with macular grid photocoagulation on diabetic macular edema

Objective　To evaluate the efficacy of macular grid photocoagulation, combined with conbercept intraocular injection for patients with diabetic macular edema (DME) by optical coherent tomography angiography (OCTA) and multifocal electroretinogram (mf-ERG), and to analyze the mechanism of treatment.Methods　Totally 80 DME patients in hospital from April in 2017 to July in 2018 were enrolled, and they were randomly divided into control group and experimental group, 40 patients in each group. Control group was treated with macular grid photocoagulation, and the experimental group was given conbercept combined with macular grid photocoagulation. OCTA and mf-ERG were used to detect macular and retinal function and visual status before treatment and at 1 month, 3 months, and 6 months after treatment. Macular foveal thickness and fluorescein leakage were detected by optical coherence tomography (OCT) and fluorescein fundus angiography (FFA).Results　There were no significant differences in foveal avascular zone (FAZ) and and macular retinal vascular density between before treatment and 1 month, 3 months, and 6 months after treatment in the both groups, as well as in visual acuity of the control group pre-treatment and post-treatment (all P>0.05). The visual acuity of the experimental group was higher than that of the control group at 3 months and 6 months after treatment and before surgery (P<0.05). The response density of P₁ and N₁ rings 1 and 4 of mf-ERGs in the experimental group at 3 months, and 6 months after treatment were higher than those in the control group, and the differences were statistically significant (both P<0.05). In the both groups, the results of OCT and FFA 1 month, 3 months, and 6 months after treatment were better than those of before treatment, the results of which after treatment 6 months were better than 1 month and 3 months after treatment, and the differences were statistically significant (all P<0.05). There was no significant difference in OCT and FFA after treatment between the two groups (all P>0.05).Conclusion　Macular grid photocoagulation combined with conbercept intraocular injection for the treatment of DME patients can significantly improve the patient’s macular, retinal structure and function, and visual acuity.