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不同注射策略治疗渗出性年龄相关性黄斑变性:一项回顾性队列研究。

Different conbercept injection strategies for the treatment of exudative age-related macular degeneration: A retrospective cohort study.

作者信息

Gao Lei, Tao Yuan, Liu Min, Li Linlin, Zhang Peng, Wang Hong, Zhang Linna

机构信息

Department of Ophthalmology, Qilu Hospital, Shandong University.

Department of Ophthalmology, Jinan 2nd People's Hospital.

出版信息

Medicine (Baltimore). 2020 Feb;99(7):e19007. doi: 10.1097/MD.0000000000019007.

Abstract

Conbercept is a novel anti-vascular endothelial growth factor for the treatment of age-related macular degeneration (AMD). The most optimal injection strategy is unknown. To assess the effectiveness of intravitreal injection of conbercept using the 3 + pro re nata (PRN) and 3 + Q3 M strategies for the treatment of exudative AMD.From January 2015 to January 2018, patients confirmed with exudative AMD at Qilu Hospital of Shandong University were included in this retrospective study. Intravitreal injection of 0.5 mg of conbercept was conducted either with the 3 + PRN or 3 + Q3 M strategy. Best-corrected visual acuity (BCVA), intraocular pressure, and optical coherence tomography were conducted at 1 and 2 weeks, then every month. fundus fluorescein angiography examination was conducted every 3 months.There were 106 eyes from 106 patients. The number of follow-ups (3 + Q3 M: 12.4 ± 1.3 vs 3 + PRN: 12.9 ± 1.6, P = .079) and the follow-up time (3 + Q3 M: 12.7 ± 0.6 vs 3 + PRN: 12.5 ± 0.7 months, P = .121) were similar in the 2 groups. The number of injections was less in 3 + PRN than 3 + Q3 M (5.3 ± 1.0 vs 6.0 ± 0.0, P < .001) The BCVA at months 7 and 9 to 12 in the 3 + Q3 M (n = 51) group were lower than for 3 + PRN (n = 55) (all P < .05). The CRT at months 9 to 12 in the 3 + Q3 M group was lower than in the 3 + PRN group (all P < .05). There were no differences between the 2 groups regarding the exudation area during follow-up. No serious treatment-related ocular complications or serious systemic adverse events were found.The 3 + PRN and 3 + Q3 M strategies of intravitreal injection of conbercept are effective in treating exudative AMD. The 3 + Q3 M strategy needs more injection but is more effective in increasing visual acuity and reducing macular CRT than the 3 + PRN strategy.

摘要

康柏西普是一种用于治疗年龄相关性黄斑变性(AMD)的新型抗血管内皮生长因子。最佳注射策略尚不清楚。为评估采用3+按需(PRN)和3+每3个月(Q3M)方案玻璃体内注射康柏西普治疗渗出性AMD的有效性。2015年1月至2018年1月,山东大学齐鲁医院确诊为渗出性AMD的患者纳入本回顾性研究。采用3+PRN或3+Q3M方案玻璃体内注射0.5mg康柏西普。在第1周和第2周进行最佳矫正视力(BCVA)、眼压和光学相干断层扫描检查,之后每月检查一次。每3个月进行一次眼底荧光血管造影检查。共106例患者的106只眼。两组的随访次数(3+Q3M:12.4±1.3 vs 3+PRN:12.9±1.6,P=0.079)和随访时间(3+Q3M:12.7±0.6 vs 3+PRN:12.5±0.7个月,P=0.121)相似。3+PRN组的注射次数少于3+Q3M组(5.3±1.0 vs 6.0±0.0,P<0.001)。3+Q3M组(n=51)在第7个月以及第9至12个月时的BCVA低于3+PRN组(n=55)(均P<0.05)。3+Q3M组在第9至12个月时的中央视网膜厚度(CRT)低于3+PRN组(均P<0.05)。两组随访期间的渗出面积无差异。未发现严重的治疗相关眼部并发症或严重的全身不良事件。玻璃体内注射康柏西普的3+PRN和3+Q3M方案在治疗渗出性AMD方面有效。3+Q3M方案需要更多次注射,但在提高视力和降低黄斑CRT方面比3+PRN方案更有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dce4/7035057/06754451054c/medi-99-e19007-g002.jpg

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