康柏西普联合全视网膜光凝治疗高危增生性糖尿病视网膜病变患者的视网膜静脉变化:一项队列研究。
Retinal vein changes in patients with high-risk proliferative diabetic retinopathy treated with conbercept and panretinal photocoagulation co-therapy: a cohort study.
机构信息
Department of Ophthalmology, Qilu Hospital of Shandong University, Jinan, China.
Department of Ophthalmology, The Second People's Hospital of Jinan, Jinan, China.
出版信息
Front Endocrinol (Lausanne). 2023 Aug 25;14:1218442. doi: 10.3389/fendo.2023.1218442. eCollection 2023.
OBJECTIVE
This study aimed to observe and compare retinal vein diameter changes and other essential indicators in patients with high-risk proliferative diabetic retinopathy (PDR) treated with intravitreal injection of conbercept (IVC) combined with panretinal photocoagulation (PRP) versus PRP monotherapy.
METHODS
A retrospective analysis was conducted on data from patients with high-risk PDR who received specific treatment and were followed up for 24 months. Among 82 patients with high-risk PDR, 50 eyes received PRP combined with IVC, whereas 32 eyes received PRP alone. During the 24-month follow-up period, changes in best-corrected visual acuity (BCVA), central foveal thickness (CFT), retinal vein diameter, number of microaneurysms (MA), neovascularization (NV) area, hard exudate (HE) area, size of the foveal avascular zone (FAZ), superficial capillary plexus (SCP) blood flow density, and adverse effects were recorded and compared between the two groups at baseline and at 6, 12, 18, and 24 months after treatment. The relationship between each observation index and vein diameter was also analyzed.
RESULTS
During the 24-month follow up, significant improvements in the BCVA, CFT, retinal vein diameter, number of MAs, NV area, HE area, FAZ, and SCP were observed in the IVC+PRP group after treatment. The PRP group only showed significant reductions in NV and HE areas. The IVC+PRP group showed significant superiority over the PRP group in improving the vein diameter, number of MA, and HE area. However, no statistically significant difference in NV area reduction was found between the groups.
CONCLUSION
In the treatment of high-risk PDR, IVC+PRP therapy has a significant advantage over PRP monotherapy. IVC+PRP therapy may reverse diabetes-induced retinal vein changes, restoring morphology and function.
目的
本研究旨在观察并比较接受康柏西普玻璃体内注射(IVC)联合全视网膜光凝(PRP)与 PRP 单一疗法治疗的高危增殖性糖尿病视网膜病变(PDR)患者的视网膜静脉直径变化和其他重要指标。
方法
对接受特定治疗并随访 24 个月的高危 PDR 患者的数据进行回顾性分析。在 82 例高危 PDR 患者中,50 只眼接受 PRP 联合 IVC 治疗,32 只眼接受 PRP 单一治疗。在 24 个月的随访期间,记录并比较两组患者在基线时以及治疗后 6、12、18 和 24 个月时最佳矫正视力(BCVA)、中心凹视网膜厚度(CFT)、视网膜静脉直径、微动脉瘤(MA)数量、新生血管(NV)面积、硬性渗出(HE)面积、中心凹无血管区(FAZ)大小、浅层毛细血管丛(SCP)血流密度的变化以及不良反应。还分析了各观察指标与静脉直径之间的关系。
结果
在 24 个月的随访期间,IVC+PRP 组治疗后 BCVA、CFT、视网膜静脉直径、MA 数量、NV 面积、HE 面积、FAZ 和 SCP 均显著改善,PRP 组仅 NV 和 HE 面积显著减小。IVC+PRP 组在改善静脉直径、MA 数量和 HE 面积方面明显优于 PRP 组。然而,两组在 NV 面积减少方面无统计学差异。
结论
在高危 PDR 的治疗中,IVC+PRP 治疗优于 PRP 单一治疗。IVC+PRP 治疗可能逆转糖尿病引起的视网膜静脉变化,恢复形态和功能。