全视网膜激光光凝术联合玻璃体腔内注射康柏西普对增生性糖尿病视网膜病变患者视功能恢复的影响

doi:10.7517/issn.1674-0475.190716

摘要/Abstract

摘要： 本文分析了全视网膜激光光凝术（PRP）联合玻璃体腔内注射康柏西普对增生性糖尿病视网膜病变（PDR）患者视功能恢复的影响。选取大足区人民医院2016年8月~2018年8月收治的PDR患者86例（86眼），按照治疗方法分为手术组和联合组，各43例。手术组采用Carl Zeiss Meditec AG激光治疗仪在眼底荧光血管造影（FFA）引导下行PRP治疗，联合组则术前72 h于玻璃体腔内注射康柏西普0.1 mL，再行PRP治疗。采用ETDRS视力表测量两组患者术前和术后4个月的视力，非接触式眼压计测量眼压，光学相干断层扫描（OCT）检查黄斑中心凹视网膜厚度（CMT），FFA检查眼底视网膜无灌注区和新生血管消退情况，统计两组患者术后并发症发生情况。术后4个月，两组视力、CMT较术前均有变化，且联合组视力较手术组明显提高，CMT较手术组明显下降，差异有统计学意义（P<0.05）。联合组视网膜无灌注区和新生血管消退率均明显高于手术组，差异有统计学意义（P<0.05）。联合组术后视网膜脱离、眼高压及视网膜出血等并发症发生率为4.65%，明显低于手术组的23.26%，差异有统计学意义（P<0.05）。研究结果显示，PRP联合玻璃体腔内注射康柏西普治疗PDR，可明显提高患者视力，降低CMT，促进已形成的无灌注区或新生血管消退，延缓视网膜新生血管增殖，改善视功能，且安全性较高，值得临床推广应用。

关键词: 增生性糖尿病视网膜病变, 全视网膜激光光凝术, 康柏西普, 视功能

Abstract: To investigate the effect of PRP combined with intravitreal injection of Conbercept on visual function recovery in patients with proliferative diabetic retinopathy (PDR), 86 patients (86 eyes) with PDR were selected from August 2016 to August 2018. According to the treatment methods, they were divided into operation group and combination group, 43 cases each. The operation group was treated with PRP guided by fundus fluorescein angiography (FFA) with Carl Zeiss Meditec AG laser therapy instrument, while the combined group was treated with 0.1 mL of Conbercept injected into vitreous cavity 72 hours before operation. The visual acuity of the two groups was measured by ETDRS visual acuity meter, non-contact tonometer, optical coherence tomography (OCT) and FFA before and 4 months after operation. The incidence of postoperative complications in the two groups was analyzed. Four months after operation, the visual acuity and CMT of the two groups were changed compared with those before operation, and the vision of the combined group was significantly improved compared with that of the operation group, while CMT was significantly decreased compared with the operation group, with statistical significance (P<0.05). Retinal non-perfusion area and the disappearance rate of neovascularization in the combined group were significantly higher than those in the operation group (P<0.05). The incidence of complications such as retinal detachment, ocular hypertension and retinal hemorrhage was 4.65% in the combined group, which was significantly lower than 23.26% in the operation group (P<0.05). PRP combined with intravitreal injection of Conbercept in the treatment of PDR can significantly improve the visual acuity of patients, reduce CMT, promote the formation of no perfusion area or the regression of neovascularization, delay the proliferation of retinal neovascularization, improve visual function, and has high safety, which is worthy of clinical application.

Key words: proliferative diabetic retinopathy, panretinal laser photocoagulation, Conbercept, visual function

陈辑. 全视网膜激光光凝术联合玻璃体腔内注射康柏西普对增生性糖尿病视网膜病变患者视功能恢复的影响[J]. 影像科学与光化学, 2020, 38(1): 87-93.

CHEN Ji. Effect of Panretinal Laser Photocoagulation Combined with Intravitreal Injection of Conbercept on Visual Function Recovery in Patients with Proliferative Diabetic Retinopathy[J]. Imaging Science and Photochemistry, 2020, 38(1): 87-93.

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