康柏西普联合阈值下激光治疗糖尿病性黄斑水肿后黄斑区血流密度及形态结构的变化

强甜甜; 赵思婕; 范宇晨; 仇蕊倩; 王宇豪; 高自清

doi:10.13898/j.cnki.issn.1000-2200.2023.11.010

康柏西普联合阈值下激光治疗糖尿病性黄斑水肿后黄斑区血流密度及形态结构的变化

Analysis of changes in macular blood flow density and morphological structure after Conbercept combined with subthreshold laser treatment of diabetic macular edema

摘要

摘要:
目的探讨康柏西普联合阈值下激光治疗糖尿病性黄斑水肿（DME）后黄斑区血流密度及黄斑区形态结构的变化。
方法选取DME病人60例（60只眼），随机将其分为对照组和观察组，各30例，观察组给予玻璃体腔内注射康柏西普联合视网膜阈值下激光治疗，阈值下激光治疗后第2天行玻璃体腔内注射康柏西普，康柏西普每月注射1次，连续注射3个月，对照组给予单纯玻璃体腔内注射康柏西普治疗，注药次数及间隔时间同观察组。分析2组治疗前后黄斑区浅层毛细血管（SCP）和深层毛细血管（DCP）血流密度、黄斑中心厚度（CMT）、最佳矫正视力（BCVA）的变化情况。
结果治疗前后，2组病人SCP血流密度组间和不同时间点差异均无统计学意义（P>0.05）；治疗前后2组病人DCP血流密度组间和不同时间点差异均有统计学意义（P < 0.01），2组病人在术后1、2、3个月随着时间的推移DCP血流密度上升（P < 0.05），但观察组的上升程度高于对照组（P < 0.01）。治疗前后，2组病人CMT和BCVA在组间和不同时间点差异均有统计学意义（P < 0.01），2组病人在术后1、2、3个月随着时间的推移CMT和BCVA均呈现下降趋势（P < 0.01），且观察组的降低程度高于对照组（P < 0.01）。
结论康柏西普联合阈值下激光及单纯玻璃体腔内注射康柏西普均可减轻DME病人的黄斑水肿，改善DCP密度，提高视功能，但康柏西普联合阈值下激光治疗DME短期内效果更显著。

Abstract:
ObjectiveTo investigate the changes of macular blood flow density and macular morphological structure after Conbercept combined with subthreshold laser treatment of diabetic macular edema (DME).
MethodsA total of 60 DME patients (60 eyes) were randomly divided into control group and observation group, with 30 cases in each group.The observation group was given glass intravitreal injection of Conbercept combined with retinal subthreshold laser treatment, on the second day after laser therapy, Conbercept was injected into the vitreous cavity once a month for 3 consecutive months.The control group was given glass intravitreal injection of Conbercept, and the injection frequency and interval were the same as those of the observation group.The changes of blood flow density of superficial capillary plexus (SCP) and deep capillary plexus (DCP), central macular thickness (CMT) and best corrected visual acuity (BCVA) before and after treatment were analyzed.
ResultsBefore and after treatment, there was no statistically significant difference in SCP blood flow density between the two groups of patients and at different time points (P>0.05);the difference in DCP blood flow density between the two groups of patients at different time points was statistically significant (P < 0.01).The DCP blood flow density of the two groups of patients increased with time at 1, 2, and 3 months after surgery (P < 0.05), but the degree of increase in the observation group was higher than that in the control group (P < 0.01).Before and after treatment, there were statistically significant differences in CMT and BCVA between the two groups of patients at different time points (P < 0.01);CMT and BCVA in both groups showed a decreasing trend with time at 1, 2, and 3 months after surgery (P < 0.01), and the degree of reduction in the observation group was higher than that in the control group (P < 0.01).
ConclusionsConbercept combined with subthreshold laser and intravitreal injection of Conbercept can reduce macular edema, improve deep vascular blood flow density, and improve visual function in DME patients.However, the short-term effect of Conbercept combined with subthreshold laser treatment of DME is more significant.

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