山东大学耳鼻喉眼学报 ›› 2024, Vol. 38 ›› Issue (3): 55-60.doi: 10.6040/j.issn.1673-3770.0.2023.504

• 论著 • 上一篇    

康柏西普治疗糖尿病合并CRVO-ME高反射点的临床观察

鲍莹1,2,刘志高2,姜鹏飞3,崔文轩1,郑晓霞1,杨梦瑶1,司明威1,王玉2,4,王红1   

  1. 1.山东大学齐鲁医院 眼科, 山东 济南 250012;
    2.济南爱尔眼科医院, 山东 济南 250100;
    3.烟台毓璜顶医院 眼科, 山东 烟台 264099;
    4.济南市第二人民医院, 山东 济南 250001
  • 发布日期:2024-06-04
  • 通讯作者: 王红. E-mail:dr.wanghong@163.com

Clinical observation of compacept in the treatment of diabetes mellitus with CRVO-ME high reflex point

BAO Ying1,2, LIU Zhigao2, JANG Pengfei3, CUI Wenxuan1, ZHENG Xiaoxia1, YANG Mengyao1, SI Mingwei1, WANG Yu2,4, WANG Hong1   

  1. 1. Department of Ophthalmology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China2. Jinan Aier Eye Hospital, Jinan 250100, Shandong, China3. Department of Ophthalmology, Yantai Yuhuangding Hospital, Yantai 264099, Shandong, China4. The Second People's Hospital of Jinan, Jinan 250001, Shandong, China
  • Published:2024-06-04

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摘要： 目的 观察康柏西普治疗糖尿病合并非缺血型视网膜中央静脉阻塞伴黄斑水肿(central retinal vein occlusion-macular edema, CRVO-ME)患者视网膜层间高反射点(hyperreflective dots, HRD)的变化。 方法 选取非缺血型CRVO-ME患者80例80眼,根据有无糖尿病分为糖尿病组40例(40眼)、非糖尿病组40例(40眼),对比分析两组患者玻璃体腔注射康柏西普(intravitreal injection of conbercept, IVC)治疗前及治疗后1、3、6个月的最佳矫正视力(best-corrected visual acuity, BCVA)、黄斑中心凹厚度(central macular thickness, CMT)、视网膜内外层HRD数量。 结果 IVC治疗后3、6个月时,非糖尿病组BCVA较糖尿病组明显提高(F=4.106,P=0.046;F=10.474,P=0.002);IVC治疗后6个月时,CMT明显降低(F=10.688,P=0.002)。两组IVC治疗前后视网膜内层HRD数量差异无统计学意义(F=1.608,P=0.209),视网膜外层HRD数量差异有统计学意义(F=4.290,P=0.042)。 结论 IVC对非缺血型CRVO-ME疗效明显。视网膜外层HRD可以作为监测炎症反应、评估预后的影像学指标。糖尿病组患者发生非缺血型CRVO-ME后,远期治疗效果较非糖尿病组差,因此,更要重视糖尿病患者的长期随访观察,避免严重并发症的发生。

关键词: 糖尿病, 非缺血型视网膜中央静脉阻塞, 玻璃体腔注射, 黄斑水肿, 高反射点

Abstract: Objective To observe the changes in hyperreflective dots(HRD)in the retina of patients with non-ischemic central retinal vein occlusion-macular edema(CRVO-ME)treated with conbercept. Methods Eighty cases and 80 eyes of non-ischemic CRVO-ME patients were selected and divided into 40 cases(40 eyes)in the diabetic group and 40 cases(40 eyes)in the non-diabetic group according to the presence or absence of diabetes mellitus. Best corrected visual acuity(BCVA), central macular thickness(CMT)and the number of HRDs in the inner and outer retinal layers were compared and analysed in the two groups before and 1, 3 and 6 months after intravitreal injection of conbercept(IVC)treatment. Results At 3 and 6 months after IVC, BCVA in the non-diabetic group was significantly higher than that in the diabetic group(F=4.106,P=0.046;F=10.474,P=0.002), and CMT was significantly lower at 6 months after IVC(F=10.688,P=0.002). There was no significant difference in the amount of HRD in the inner retina between the two groups before and after IVC(F=1.608,P=0.209), but there was a significant difference in the amount of HRD in the outer retina(F=4.290,P=0.042). Conclusion IVC is effective in the treatment of non-ischemic CRVO-ME. HRD in the outer layer of the retina can be used as an imaging marker to monitor the inflammatory response and assess prognosis. The long-term therapeutic effect of non-ischemic CRVO-ME in diabetic group is worse than in non-diabetic group. Therefore, more attention should be paid to the long-term follow-up of diabetic patients to avoid serious complications.

Key words: Diabetes, Non-ischemic central retinal vein occlusion, Intravitreal injection, Macular edema, High reflective points

中图分类号: 

  • R587.1
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