玻璃体腔注射康柏西普和曲安奈德治疗非动脉炎性前部缺血性视神经病变的比较研究

目的 分析康柏西普和曲安奈德治疗非动脉炎性前部缺血性视神经病变患者的临床疗效。方法 选取2017年9月—2019年1月濮阳市眼科医院收治的非动脉炎性前部缺血性视神经病变患者80例，随机分为对照组（40例）和治疗组（40例）。对照组注射醋酸曲安奈德注射液，4 mg/次。治疗组注射康柏西普眼用注射液，0.05 mL/（眼·次）。比较治疗前后两组患者视力和视野调查结果，眼压、神经纤维层厚度和视盘水肿消退时间，及玻璃体液中血管内皮生长因子-A（VEGF-A）水平。结果 治疗后，对照组视力和视野总有效率分别为80.00%和90.00%，均显著低于治疗组的95.00%和100.00%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者眼压及神经纤维层厚度均明显降低（P<0.05），且治疗组患者眼压、神经纤维层厚度、视盘水肿消退时间均明显低于对照组（P<0.05）。最后1次治疗时，两组患者玻璃体腔中VEGF-A水平均明显降低（P<0.05），且治疗组明显低于对照组（P<0.05）。结论 玻璃体腔注射康柏西普可显著提高非动脉炎性前部缺血性视神经病变患者的视力和视野，有效改善治疗临床疗效。

Comparative study on intravitreal injection of conbercept and triamcinolone in treatment of non-arteritic anterior ischemic optic neuropathy

Objective To analyze the clinical efficacy of intravitreal injection of conbercept and triamcinolone in treatment of non-arteritic anterior ischemic optic neuropathy. Methods Patients (80 cases) with non-arteritic anterior ischemic optic neuropathy in Puyang Eye Hospital from September 2017 to January 2019 were randomly divided into control (40 cases) and treatment (40 cases) groups. Patients in the control group were intravitreal administered with Triamcinolone Acetonide Acetate Injection, 4 mg/time. Patients in the treatment group were intravitreal administered with Conbercept Ophthalmic Injection, 0.05 mL/(eye∙time). After treatment, treatment results of visual acuity and visual field, intraocular pressure, the thickness of nerve fiber layer, the extinction time of optic disc edema, the VEGF-A level in vitreous humor in two groups before and after treatment were compared. Results After treatment, the efficiency of visual acuity and field in the control group were 80.00% and 90.00%, which were significantly lower than 95.00% and 100.00% in the treatment group, respectively, and there were differences between two groups (P<0.05). After treatment, the intraocular pressure and the thickness of nerve fiber layer in two groups were significantly decreased (P<0.05), and the intraocular pressure, the thickness of nerve fiber layer, the extinction time of optic disc edema in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the VEGF-A level in vitreous humor in two groups was significantly decreased (P<0.05), and which in the treatment group was significantly lower than that in the control group (P<0.05). Conclusions The intravitreal injection of conbercept can significantly improve the vision and visual field of patients with non-arteritic anterior ischemic optic neuropathy, and effectively improve the clinical efficacy.