与玻璃体内注射康柏西普治疗糖尿病性黄斑水肿的临床反应相关的肾功能障碍
Renal dysfunction associated with clinical response to intravitreal conbercept therapy for diabetic macular edema.
作者信息
Wu Wei, Liu Hui-Dong, Xiao Xue, Wang Ya-Xin, Feng Song-Fu, Liu Jia-Qi, Yuan Yong-Gang, Lu Xiao-He
机构信息
Department of Ophthalmology, GuangZhou Red Cross Hospital of Jinan University, Guangzhou 510000, Guangdong Province, China.
Department of Ophthalmology, Zhujiang Hospital of Southern Medical University, Guangzhou 510280, Guangdong Province, China.
出版信息
Int J Ophthalmol. 2025 Mar 18;18(3):454-461. doi: 10.18240/ijo.2025.03.12. eCollection 2025.
AIM
To investigate the impact of renal dysfunction on clinical response to intravitreal conbercept injection (IVC) for diabetic macular edema (DME).
METHODS
This retrospective study included a total of 100 eyes from 100 patients with DME treated with IVC with 3+PRN regimen. Based on the estimated glomerular filtration rate (eGFR), the patients were divided into normal renal function group (=37), impaired renal function group (=27), and renal insufficiency group (=36). The main outcome measures were best-corrected visual acuity (BCVA) and central subfield macular thickness (CST). Clinical parameters included blood urea nitrogen, serum creatinine, serum uric acid, glycosylated hemoglobin (HbA1c), and hemoglobin.
RESULTS
The mean follow-up time was 3.9mo. The mean number of IVCs was 2.07±1.22 in the three groups. Mean BCVA improved significantly from 0.81±0.49 logMAR at baseline to 0.72±0.52 logMAR in the three groups at the final visit (<0.001). Mean CST decreased significantly from 427.85±148.99 µm at baseline to 275.31±108.31 µm at final visit (<0.001). Patients in the normal renal function group had higher baseline hemoglobin levels and thinner baseline CST than those in the impaired renal function and insufficiency renal function group (all <0.001). Patients in the normal renal function group had higher baseline hemoglobin levels and thinner baseline CST than those in the impaired renal function and insufficiency renal function group (all <0.001). The three groups had no differences in baseline HbA1c levels (>0.05). Good baseline BCVA (logMAR, =0.001) and thicker baseline CST (=0.041) were associated with visual acuity improvement. Higher eGFR (<0.001), hemoglobin (=0.032) and thicker baseline CST (=0.017) were associated with macular edema retrogression in the conbercept-treated diabetic patients, which showed better anatomical response to IVC.
CONCLUSION
Our results indicate that the renal dysfunction is the risk factor associated with the efficacy of IVC for DME.
目的
探讨肾功能不全对糖尿病性黄斑水肿（DME）患者玻璃体内注射康柏西普（IVC）临床疗效的影响。
方法
本回顾性研究纳入了100例接受3+PRN方案IVC治疗的DME患者的100只眼。根据估计肾小球滤过率（eGFR），将患者分为肾功能正常组（=37）、肾功能受损组（=27）和肾功能不全组（=36）。主要观察指标为最佳矫正视力（BCVA）和黄斑中心凹厚度（CST）。临床参数包括血尿素氮、血清肌酐、血清尿酸、糖化血红蛋白（HbA1c）和血红蛋白。
结果
平均随访时间为3.9个月。三组患者IVC的平均次数为2.07±1.22次。三组患者的平均BCVA从基线时的0.81±0.49 logMAR显著提高至末次随访时的0.72±0.52 logMAR（<0.001）。平均CST从基线时的427.85±148.99 µm显著降低至末次随访时的275.31±108.31 µm（<0.001）。肾功能正常组患者的基线血红蛋白水平高于肾功能受损组和肾功能不全组，基线CST低于肾功能受损组和肾功能不全组（均<0.001）。三组患者的基线HbA1c水平无差异（>0.05）。良好的基线BCVA（logMAR，=0.001）和较厚的基线CST（=0.041）与视力改善相关。较高的eGFR（<0.001）、血红蛋白（=0.032）和较厚的基线CST（=0.017）与接受康柏西普治疗的糖尿病患者黄斑水肿消退相关，这表明IVC具有更好的解剖学疗效。
结论
我们的结果表明，肾功能不全是与IVC治疗DME疗效相关的危险因素。
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