Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Ophthalmology, Zhongshan Hospital, Fudan University, Shanghai, China.
Eye (Lond). 2020 Mar;34(3):523-529. doi: 10.1038/s41433-019-0516-x. Epub 2019 Jul 29.
The objective of this study is to evaluate the progression and new onset of macular retinoschisis (MRS) in the patients treated with intravitreal Conbercept injections for myopic choroidal neovascularization (mCNV).
Post-hoc analysis of 160 mCNV patients included in SHINY study was performed to evaluate the impact of Conbercept injection on MRS in patients with mCNV undergoing intravitreal Conbercept injections. The patients were 3:1 randomized to the study group (three loading dose and thereafter pro re nata [PRN]) and the control group (3 months' sham injection, then one Conbercept injection at month 4 and thereafter PRN). MRS was assessed with optical coherence tomography by masked graders.
At baseline, 28 of 122 eyes in study group and 10 of 38 eyes in control group had MRS. At month 3, two patients showed MRS progression and one patient had new onset MRS in study group. No MRS progression nor new onset MRS was found in the control group. At final visit, the cumulative incidence of MRS was 1.3% (2/160). Both Spearman's correlation and multiple logistic regression demonstrated no association between the progression and new onset of MRS and intravitreal injection frequency (correlation coefficient = 0.017, P = 0.851 and odds ratio = 0.996, P = 0.982). In addition, baseline vitreoretinal adhesion was the most likely potential risk factor resulting in MRS progression (odds ratio = 4.566, P = 0.027). Furthermore, MRS progression was more likely to take place in outer retinal layers.
The progression and new onset of MRS was not associated with the frequency of intravitreal Conbercept injections.
本研究旨在评估玻璃体内康柏西普注射治疗近视性脉络膜新生血管（mCNV）患者中黄斑视网膜劈裂（MRS）的进展和新发病例。
对 SHINY 研究中纳入的 160 例 mCNV 患者进行了一项回顾性分析，以评估玻璃体内康柏西普注射对接受玻璃体内康柏西普注射的 mCNV 患者 MRS 的影响。患者以 3:1 的比例随机分为研究组（三次负荷剂量，之后根据需要治疗）和对照组（三个月假注射，然后在第四个月注射一次康柏西普，之后根据需要治疗）。采用光学相干断层扫描对 MRS 进行评估，由盲法评分者进行评估。
基线时，研究组 122 只眼中有 28 只、对照组 38 只眼中有 10 只患有 MRS。在第 3 个月时，研究组有 2 例患者出现 MRS 进展，1 例患者出现新发病例 MRS。对照组中未发现 MRS 进展或新发病例 MRS。在最终随访时，MRS 的累积发生率为 1.3%（2/160）。Spearman 相关性和多因素逻辑回归均表明，MRS 的进展和新发病例与玻璃体内注射频率之间无相关性（相关系数为 0.017，P=0.851；比值比为 0.996，P=0.982）。此外，基线时的玻璃体视网膜粘连是导致 MRS 进展的最可能潜在危险因素（比值比为 4.566，P=0.027）。此外，MRS 进展更可能发生在外视网膜层。
MRS 的进展和新发病例与玻璃体内康柏西普注射的频率无关。
