玻璃体内注射康柏西普对渗出性老年性黄斑变性患者脉络膜厚度的影响

目的　观察玻璃体内注射康柏西普对渗出性老年性黄斑变性（ａｇｅ-ｒｅｌａｔｅｄｍａｃｕｌａｒｄｅｇｅｎｅｒａｔｉｏｎ，ＡＭＤ）患者脉络膜厚度（ｃｈｏｒｏｉｄａｌｔｈｉｃｋｎｅｓｓ，ＣＴ）的影响。方法　确诊为渗出性ＡＭＤ患者４２例４２眼，分为典型ＡＭＤ（ｔｙｐｉｃａｌ-ＡＭＤ，ｔＡＭＤ）组和息肉样血管病变（ｐｏｌｙｐｏｉｄａｌｃｈｏｒｏｉｄａｌｖａｓｃｕｌｏｐａｔｈｙ，ＰＣＶ）组，均行３＋ＰＲＮ方案的玻璃体内注射康柏西普治疗。采用光学相干断层扫描的增强深度成像技术测量治疗前及初次治疗后１个月、２个月、３个月、６个月治疗眼及对侧眼中心凹下脉络膜厚度（ｓｕｂｆｏｖｅａｌｃｈｏｒｏｉｄａｌｔｈｉｃｋｎｅｓｓ，ＳＦＣＴ）及距离中心凹１ｍｍ的鼻侧和颞侧ＣＴ，对比分析康柏西普治疗前后的ＣＴ变化。结果　渗出性ＡＭＤ患眼玻璃体内注射康柏西普后１个月、２个月、３个月、６个月ＳＦＣＴ分别为（２２３．５５±３０．７１）μｍ、（２２１．５２±３３．３７）μｍ、（２１４．４３±３１．８１）μｍ、（２１４．９３±３１．４１）μｍ；治疗后６个月鼻侧ＣＴ从（２２５．４０±４３．９７）μｍ减少至（２０５．７１±４２．２０）μｍ，颞侧ＣＴ从（２３５．２１±４７．２２）μｍ降至（２０３．５２±３９．１５）μｍ；与基线相比，差异均具有统计学意义（均为Ｐ＜０．００１）。其中，ｔＡＭＤ组ＳＦＣＴ从（２３４．０６±４１．０４）μｍ减至（２０９．１９±３２．１４）μｍ，ＰＣＶ组从（２７４．６０±２７．７３）μｍ减至（２３３．３０±２１．０８）μｍ，各随访时间点所测ＳＦＣＴ与基线时相比差异均具有统计学意义（均为Ｐ＜０．０５），而对侧正常眼６个月各时间点ＳＦＣＴ无明显改变。结论　玻璃体内注射康柏西普会引起渗出型ＡＭＤ（ｔＡＭＤ和ＰＣＶ）ＣＴ降低。

Effects of intravitreal conbercept injections on choroidal thickness in exudative age-related macular degeneration

Objective To observe the effects ofintravitreal conberceptinjections on choroidal thickness ( CT) in exudative age-related macular degeneration ( AMD). Methods Forty-two patients (42 eyes) with exudative AMD who received 3 + PRN intravitreal conbercept injection treatment over a 6-month period were divided into two groups: tipical AMD ( t-AMD) group and polypoidal choroidal vasculopathy ( PCV) group. High-definition optical coherence tomography with enhanced depth imaging mode was used to measure the subfoveal choroidal thickness ( SFCT) ,nasal and temporal l mm near to the center of the fovea of the affected eyes and the fellow eyes before and after the treatment at l month,2 months. 3 months and 6 months. The changes of CT before and after use of conbercept was compared. Results Of all the patients, subfoveal choroidal thickness at l month,2 months,3 months and 6 months after injection were ( 223. 55 + 30. 71) ym, ( 221. 52 + 33. 37 ) ym, ( 214. 43 + 31. 81) ym, ( 214. 93 + 31. 41) pLm,respectively; Nasal CT decreased from ( 225. 40 + 43. 97 ) pLm to ( 205. 71 + 42. 20 ) pLm and temporal CT decreased from(235. 21 +47. 22) Vm to (203. 52 +39. 15) pum,and there were statistical sigruficant differences corupared with baseline ( all P < 0. 001). SFCT of typical-AMD eyes decreased from ( 234. 06 +41. 04) ym to ( 209. 19 +32. 14) ym,while the PCV eyes reduced from( 274. 60 +27. 73) ym to ( 233. 3 +21. 08 ) ym,and there were statistical significant differences compared with baseline ( all P < 0. 05 ) . SFCT variations of the fellow eyes showed no statistical significant differences.Conclusion A significant reduction in CT is noted after intravitreal conbercept injections in exudative AMD.