577 nm阈值下微脉冲激光联合抗VEGF药物治疗难治性糖尿病性黄斑水肿的疗效观察

doi:10.6040/j.issn.1673-3770.0.2023.313

Abstract

Abstract: Objective We compared the clinical efficacy of subthreshold micropulse laser photocoagulation(SMLP)with a threshold of 577 nm, combined with intravitreal injection of compacept(intravitreal conbercept, IVC), with that of IVC alone in the treatment of refractory diabetic macular edema(DME). Methods We designed and performed a non-randomized controlled study. Patients with refractory DME who were admitted to the Department of Ophthalmology, Hunan Provincial People's Hospital from January 2022 to December 2022 were selected and divided into an experimental group(10 cases, 16 eyes)and a control group(12 cases, 17 eyes). The experimental group received 577 nm SMLP combined with IVC treatment, and the control group received IVC alone. The changes in best corrected visual acuity(BCVA), central macular retinal thickness(CMT), hard exudates(HE)area, microangioma(MA), and the number of intravitreal injections were collected after 6 months of treatment in the two groups. The incidence of complications was recorded after treatment. Results After 6 months of treatment, the respective Log MAR BCVA values in the experimental and control groups were 0.300(0.100, 0.400)and 0.400(0.300, 0.600), respectively. The difference between these two groups was statistically significant(t=-2.575, P=0.015). The respective CMT values were 237.00(230.75, 254.75)μm and 263.00(237.00, 341.50)μm, and the difference was statistically significant(t=-2.252, P=0.035). No significant difference was observed between HE ［411.50(72.25, 8 757.50)pixels²］ vs. ［3 000.00(10.00, 6 604.00)pixels²］ and MA ［1.00(0.00, 7.25)vs.(4.55±4.78)］(t=0.766, P=0.452; t=-0.861, P=0.400). The numbers of injections in the experimental and control groups were(4.6±0.2)and(5.3±0.2), respectively. This difference was statistically significant(t=-2.182, P=0.039). After 6 months of treatment, no obvious pigment deposition or sign of laser scar was observed in the fundus examination of the affected eyes in the experimental group. No obvious complications were observed in the experimental group or the control group after 6 months of treatment. Conclusion SMLP at 577 nm demonstrated good safety. Compared with simple IVC treatment, 577 nm SMLP combined with IVC treatment improves HE area, number of bleeding points, and MA with the same efficacy in patients with refractory DME. However, combined treatment can better reduce macular edema in some patients in the short term, improve BCVA, prolong the interval of intravitreal injection, and reduce the frequency of intravitreal injection, offering promising prospects for clinical application.

Key words: Subthreshold micropulse laser photocoagulation, Diabetic macular edema, Conbercept, Effect observation

CLC Number:

R774.1

ZHOU Jinglin, LI Jinxiang, ZENG Qi. Effect of 577 nm subthreshold micropulse laser photocoagulation combined with anti-VEGF on the treatment of refractory diabetic macular edema[J].Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(2): 18-25.

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Effect of 577 nm subthreshold micropulse laser photocoagulation combined with anti-VEGF on the treatment of refractory diabetic macular edema

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