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康柏西普玻璃体腔内注射治疗病理性近视脉络膜新生血管的预后因素。

Prognostic factors for intravitreal conbercept in the treatment of choroidal neovascularization secondary to pathological myopia.

机构信息

Ophthalmology Department, Huizhou Municipal Central Hospital, Huizhou, 516000, Guangdong, China.

出版信息

Int Ophthalmol. 2024 Jun 22;44(1):253. doi: 10.1007/s10792-024-03177-8.

Abstract

PURPOSE

To identify risk factors influencing visual outcomes in patients with pathological myopia-associated choroidal neovascularization (PM-CNV) following intravitreal injections of conbercept.

METHODS

A total of 86 eyes from 86 patients received intravitreal conbercept in a 1 + PRN regimen. After the initial injection, patients were followed for 12 months. They were categorized into two groups based on their 12-month visual acuity change: those who achieved greater than a one-line improvement in BCVA (improved group; n = 65) and those who experienced a one-line or lesser improvement or a decrease in BCVA (non-improved group; n = 21).

RESULTS

Over the 12-month period, the mean BCVA in the improved group significantly improved from 0.82 to 0.41 LogMAR. In the non-improved group, BCVA changed from 1.24 to 1.09 LogMAR. Similarly, the mean CRT decreased from 426.21 μm at baseline to 251.56 μm at 12 months in the improved group, and from 452.47 to 382.45 μm in the non-improved group. Multivariable logistic regression analyses revealed that older age (OR 1.287; 95% CI 1.019-1.625; P = 0.034), poorer baseline BCVA (OR 6.422; 95% CI 1.625-25.384; P = 0.008), the presence of subfoveal CNV (OR 4.817; 95% CI 1.242-18.681; P = 0.023), and organized interlacing patterns of CNV morphology (OR 5.593; 95% CI 1.397-22.392; P = 0.015) emerged as independent risk factors correlated with worsened visual prognosis following intravitreal conbercept injections.

CONCLUSIONS

Conbercept demonstrates significant efficacy and safety in treating PM-CNV. Key factors influencing visual recovery post-treatment include older age, poorer baseline BCVA, the presence of subfoveal CNV, and organized interlacing patterns of CNV morphology.

摘要

目的

探讨康柏西普玻璃体腔注射治疗病理性近视脉络膜新生血管(PM-CNV)的疗效及其影响因素。

方法

回顾性分析 2017 年 1 月至 2019 年 1 月在我院接受玻璃体腔注射康柏西普治疗的 86 例(86 眼)PM-CNV 患者的临床资料。所有患者均给予玻璃体腔注射康柏西普 1+PRN 方案治疗。治疗后随访 12 个月,比较不同视力改善情况患者的一般资料和眼底检查结果。

结果

最终有 65 例(75.6%)患者视力改善≥1 行,21 例(24.4%)患者视力改善<1 行或无变化,甚至下降。视力改善组治疗后最佳矫正视力(BCVA)从 0.82 提高至 0.41 LogMAR,中央视网膜厚度(CRT)从治疗前的(426.21±101.65)μm 降低至(251.56±91.08)μm;视力无改善组治疗后 BCVA 从 1.24 提高至 1.09 LogMAR,CRT 从(452.47±101.72)μm 降低至(382.45±101.58)μm。多因素 logistic 回归分析显示,年龄较大(OR=1.287,95%CI:1.0191.625,P=0.034)、基线 BCVA 较差(OR=6.422,95%CI:1.62525.384,P=0.008)、CNV 位于黄斑中心凹下(OR=4.817,95%CI:1.24218.681,P=0.023)、CNV 形态呈杂乱交织状(OR=5.593,95%CI:1.39722.392,P=0.015)是影响患者治疗后视力预后的独立危险因素。

结论

康柏西普玻璃体腔注射治疗 PM-CNV 安全有效,患者年龄、基线 BCVA、CNV 位置及形态是影响患者治疗后视力恢复的主要因素。

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