康柏西普联合全视网膜光凝与全视网膜光凝单独治疗高危增殖性糖尿病视网膜病变的疗效比较。
A comparison between the therapeutic effects of Conbercept combined with panretinal photocoagulation and panretinal photocoagulation monotherapy for high-risk proliferative diabetic retinopathy.
机构信息
Department of Ophthalmology, Peking University People's Hospital, Beijing, China.
Eye Diseases and Optometry Institute, Beijing, China.
出版信息
Front Endocrinol (Lausanne). 2023 Jan 13;13:1038757. doi: 10.3389/fendo.2022.1038757. eCollection 2022.
OBJECTIVE
To compare the therapeutic effects of the administration of intravitreal Conbercept (IVC) plus panretinal photocoagulation (PRP) to that of PRP monotherapy in patients with high-risk proliferative diabetic retinopathy (PDR).
METHODS
In this retrospective consecutive case series, we analyzed the data on high-risk PDR patients followed up for 12 months. Patients were divided into two groups: the IVC+PRP group and the PRP monotherapy group. Patients in the IVC+PRP group were initially administered 3 IVC injections and PRP, while patients in the PRP monotherapy group received PRP only. Depending on the grouping criteria, patients in both groups were administered either IVC+PRP or PRP only if the neovascularization (NV) did not regress. From the initiation to month 12 of treatment, we recorded and compared the data on the NV regression rate, improvement in best-corrected visual acuity (BCVA), laser spots, changes in central macular thickness (CMT), complications, and the need for vitrectomy for all patients.
RESULTS
In this study, 79 eyes of 58 patients in the IVC+PRP group and 86 eyes of 60 patients in the PRP monotherapy group were included. During the follow-up of 12 months, the number of eyes with complete regression, partial regression, and no regression or increase in NV were 56 (70.88%), 23 (29.12%), and 0 (0%) in the IVC+PRP group and 13 (15.12%), 50 (58.14%), and 23 (26.74%) in the PRP group ( < 0.001). The BCVA was significantly higher and CMT was lower in the patients of the IVC+PRP group than in the PRP monotherapy group at 3, 6, and 12 months of follow-up ( < 0.05). The mean number of laser spots was lower in the patients of the IVC+PRP group than in the PRP group (1,453 ± 87 spots vs. 2,267 ± 94 spots, < 0.05). A significantly lower percentage of patients in the IVC+PRP group underwent vitrectomy than that in the PRP group (7 (8.86%) vs. 27 (31.40%), < 0.001).
CONCLUSION
High-risk PDR patients treated with IVC + PRP showed a higher rate of NV regression, more effective improvement in the BCVA, and lower vitrectomy rate compared to those who were administered PRP monotherapy.
目的
比较玻璃体内注射康柏西普（IVC）联合全视网膜光凝（PRP）与 PRP 单一疗法治疗高危增殖性糖尿病视网膜病变（PDR）患者的疗效。
方法
本回顾性连续病例系列研究纳入了随访 12 个月的高危 PDR 患者的数据。患者分为两组：IVC+PRP 组和 PRP 单一疗法组。IVC+PRP 组患者最初接受 3 次 IVC 注射和 PRP，而 PRP 单一疗法组患者仅接受 PRP。根据分组标准，如果新生血管（NV）未消退，两组患者均给予 IVC+PRP 或 PRP。从治疗开始到第 12 个月，我们记录并比较了两组患者 NV 消退率、最佳矫正视力（BCVA）改善、激光光斑、中央黄斑厚度（CMT）变化、并发症以及所有患者玻璃体切除术的需要。
结果
本研究纳入了 IVC+PRP 组 58 例 79 眼和 PRP 单一疗法组 60 例 86 眼。在 12 个月的随访期间，IVC+PRP 组完全消退、部分消退和无消退或 NV 增加的眼数分别为 56 眼（70.88%）、23 眼（29.12%）和 0 眼（0%），PRP 组分别为 13 眼（15.12%）、50 眼（58.14%）和 23 眼（26.74%）（<0.001）。在 3、6 和 12 个月的随访中，IVC+PRP 组患者的 BCVA 明显更高，CMT 更低（<0.05）。IVC+PRP 组患者的平均激光光斑数低于 PRP 组（1453±87 个光斑比 2267±94 个光斑，<0.05）。IVC+PRP 组接受玻璃体切除术的患者比例明显低于 PRP 组（7 例[8.86%]比 27 例[31.40%]，<0.001）。
结论
与接受 PRP 单一疗法的患者相比，接受 IVC+PRP 治疗的高危 PDR 患者 NV 消退率更高，BCVA 改善更有效，玻璃体切除术率更低。
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