Zhu Yanxia, Li Jun, Yu Songping, Mao Bangxun, Ying Jia
Department of Ophthalmology, Lishui Municipal Central Hospital, Lishui, Zhejiang 323000, China.
Emerg Med Int. 2022 May 18;2022:1348855. doi: 10.1155/2022/1348855. eCollection 2022.
To compare the curative effect of intravitreal injection of triamcinolone acetonide and aflibercept on diabetic retinopathy (DR) cystoid macular edema. A total of 102 patients with DR cystoid macular edema admitted to the hospital were enrolled between July 2018 and July 2021. According to random number table method, they were divided into the control group (intravitreal injection of triamcinolone acetonide) and the observation group (intravitreal injection of aflibercept), 51 cases in each group. All were followed up for half a year. The clinical curative effect, visual acuity, central subfield macular thickness (CSMT), macular volume, scores of quality of life, and levels of cytokines in aqueous humor (vascular endothelial growth factor (VEGF), monocyte chemoattractant protein-1 (MCP-1), human angiopoietin-like protein 4 (ANGPTL4)] at different time points (before and at 6 months after surgery) were compared between the two groups. The times of drugs injection and occurrence of adverse reactions in both groups were statistically analyzed. The total effective rate in observation group was higher than that in the control group (96.08% 82.35%) ( < 0.05). After 6 months of treatment, visual acuity was improved, and CSMT and macular volume were decreased in both groups. Also, the above changes were more significant in the observation group than those in the control group ( < 0.05). After 6 months of treatment, levels of cytokines in aqueous humor were decreased in both groups. The levels of VEGF, MCP-1, and ANGPTL4 in observation group were lower than those in the control group ( < 0.05). After 6 months of treatment, quality of life scores in observation group were higher than those in the control group ( < 0.05). In the follow-up period, average times of drugs injection in the observation group were more than those in the control group, and the incidence of adverse reactions was lower than that in control group (5.88% 21.57%) ( < 0.05). The curative effect of intravitreal injection of both triamcinolone acetonide and aflibercept is good on DR cystoid macular edema. The curative effect of aflibercept is better, which can improve visual acuity and quality of life, and regulate cytokines in aqueous humor, with high safety. However, aflibercept has a high price, and further research is needed to determine whether its price can be matched with clinical benefits. In clinic, medication plan should be selected according to the actual situation.
比较玻璃体内注射曲安奈德和阿柏西普治疗糖尿病性视网膜病变（DR）黄斑囊样水肿的疗效。选取2018年7月至2021年7月期间收治的102例DR黄斑囊样水肿患者。按照随机数字表法将其分为对照组（玻璃体内注射曲安奈德）和观察组（玻璃体内注射阿柏西普），每组51例。全部随访半年。比较两组不同时间点（手术前及术后6个月）的临床疗效、视力、黄斑中心子野厚度（CSMT）、黄斑体积、生活质量评分及房水中细胞因子[血管内皮生长因子（VEGF）、单核细胞趋化蛋白-1（MCP-1）、人血管生成素样蛋白4（ANGPTL4）]水平。对两组的药物注射次数及不良反应发生情况进行统计学分析。观察组总有效率高于对照组（96.08%比82.35%）（P<0.05）。治疗6个月后，两组视力均提高，CSMT及黄斑体积均减小，且观察组上述变化较对照组更显著（P<0.05）。治疗6个月后，两组房水中细胞因子水平均降低，观察组VEGF、MCP-1及ANGPTL4水平低于对照组（P<0.05）。治疗6个月后，观察组生活质量评分高于对照组（P<0.05）。随访期间，观察组平均药物注射次数多于对照组，不良反应发生率低于对照组（5.88%比21.57%）（P<0.05）。玻璃体内注射曲安奈德和阿柏西普治疗DR黄斑囊样水肿疗效均较好，阿柏西普疗效更佳，可提高视力及生活质量，调节房水中细胞因子，安全性高。但阿柏西普价格昂贵，其价格与临床获益是否匹配尚需进一步研究确定。临床中应根据实际情况选择用药方案。
