Zhao Tong, Chen You, Zhang Hong-Song, Chen Yi, Wang Zhi-Jun
Department of Ophthalmology, China-Japan Friendship Hospital, Beijing 100029, China.
Int J Ophthalmol. 2022 Apr 18;15(4):609-614. doi: 10.18240/ijo.2022.04.14. eCollection 2022.
To explore the efficacy of conbercept after switching from bevacizumab/ranibizumab in eyes of central retinal vein occlusion (CRVO) through optical coherence tomography angiography (OCTA).
Patients with prior treatment of a minimum of three consecutive intravitreal injections of either bevacizumab or ranibizumab, followed by injection of conbercept, were recruited. The minimal follow-up period after switching was 12mo. Central retinal thickness (CRT), best-corrected visual acuity (BCVA), the interval of injections was reviewed. Perfusion density (PD) and vascular length density (VLD) of superficial and deep capillary plexus were acquired from OCTA images before and after switching.
Twenty-four eyes were included. CRT significantly decreased from 460.71±153.23 µm (before switching) to 283.92±38.27 µm at the end of follow-up (<0.001). However, BCVA gained to some extent (from 0.98±0.33 to 0.76±0.42 logMAR) but the difference was not significant (=0.070). After switching to conbercept the injection interval extended from 5.2±2.3wk to 8.3±3.9wk (=0.012). At the end of follow-up, PD of deep retinal layer decreased significantly compared with before switching (from 34.62%±5.27% to 33.26%±5.82%, =0.016), similar result was found in VLD of deep retinal layer but not in PD or VLD in superficial layer.
In cases of refractory macular edema secondary to CRVO, switching to conbercept improves macular thickness and extends interval of injection. Retinal microvasculature cannot improve with treatment of conbercept.
通过光学相干断层扫描血管造影(OCTA)探讨在视网膜中央静脉阻塞(CRVO)患者眼中从贝伐单抗/雷珠单抗转换为康柏西普后的疗效。
招募先前至少连续三次玻璃体腔内注射贝伐单抗或雷珠单抗,随后注射康柏西普的患者。转换后的最短随访期为12个月。回顾中心视网膜厚度(CRT)、最佳矫正视力(BCVA)、注射间隔。从转换前后的OCTA图像中获取浅层和深层毛细血管丛的灌注密度(PD)和血管长度密度(VLD)。
纳入24只眼。随访结束时,CRT从转换前的460.71±153.23 µm显著降至283.92±38.27 µm(<0.001)。然而,BCVA有一定程度的提高(从0.98±0.33提高到0.76±0.42 logMAR),但差异不显著(=0.070)。转换为康柏西普后,注射间隔从5.2±2.3周延长至8.3±3.9周(=0.012)。随访结束时,与转换前相比,深层视网膜层的PD显著降低(从34.62%±5.27%降至33.26%±5.82%,=0.016),深层视网膜层的VLD也有类似结果,但浅层的PD或VLD没有变化。
在CRVO继发的难治性黄斑水肿病例中,转换为康柏西普可改善黄斑厚度并延长注射间隔。康柏西普治疗不能改善视网膜微血管系统。