[1]洪婷婷,刘广峰,高新晓,等.糖尿病黄斑水肿玻璃体内注射康柏西普的短期疗效和椭圆体带完整性改变的观察[J].眼科新进展,2017,37(11):1053-1056.[doi:10.13389/j.cnki.rao.2017.0266]
 HONG Ting-Ting,LIU Guang-Feng,GAO Xin-Xiao,et al.Short-term outcomes of intravitreal injection of conbercept for diabetic macular edema and restoration of ellipsoid zone[J].Recent Advances in Ophthalmology,2017,37(11):1053-1056.[doi:10.13389/j.cnki.rao.2017.0266]
点击复制

糖尿病黄斑水肿玻璃体内注射康柏西普的短期疗效和椭圆体带完整性改变的观察/HTML
分享到:

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
37卷
期数:
2017年11期
页码:
1053-1056
栏目:
应用研究
出版日期:
2017-11-05

文章信息/Info

Title:
Short-term outcomes of intravitreal injection of conbercept for diabetic macular edema and restoration of ellipsoid zone
作者:
洪婷婷刘广峰高新晓范颖汪军
100029 北京市,首都医科大学附属北京安贞医院(洪婷婷,高新晓,范颖,汪军);102206 北京市,北京大学国际医院眼科(刘广峰)
Author(s):
HONG Ting-TingLIU Guang-FengGAO Xin-XiaoFan YingWANG Jun
Department of Ophthalmology,Beijing Anzhen Hospital,Capital Medical University(HONG Ting-Ting,GAO Xin-Xiao,FAN Ying,WANG Jun),Beijing 100029,China;Department of Ophthalmology,Peking University International Hospital(LIU Guang-Feng),Beijing 102206,China
关键词:
糖尿病视网膜病变黄斑水肿血管形成抑制剂抗体
Keywords:
diabetic retinopathymacular edemaangiogenesis inhibitorsantibody
分类号:
R774.1
DOI:
10.13389/j.cnki.rao.2017.0266
文献标志码:
A
摘要:
目的 评估糖尿病黄斑水肿(diabetic macular edema,DME)患者玻璃体内注射康柏西普的短期疗效并观察椭圆体带(ellipsoid zone,EZ)完整性改变情况。方法 DME患者14例(16眼),所有患眼均行玻璃体内注射康柏西普治疗。在注射后1个月、2个月、3个月时分别复查最佳矫正视力(best corrected visual acuity,BCVA)、光学相干断层扫描(optical coherence tomography,OCT)。比较注射前与注射后1个月、2个月、3个月的logMAR BCVA、黄斑体积和黄斑中心凹视网膜厚度(central foveal thickness,CFT)以及注射前与注射后3个月的中心凹EZ不完整部分的横断面长度。结果 患眼注射前logMAR BCVA为0.79±0.08,CFT为(536.44±35.87)μm,黄斑体积为(11.27±0.37)mm3。注射后1个月患眼logMAR BCVA为(0.65±0.07),CFT为(385.63±22.60)μm,黄斑体积为(10.21±0.22)mm3。注射后2个月患眼logMAR BCVA为0.56±0.06,CFT为(336.13±21.91)μm,黄斑体积为(9.69±0.17)mm3。注射后3个月患眼logMAR BCVA为0.52±0.06,CFT为(292.38±22.54)μm,黄斑体积为(9.30±0.20)mm3。两两比较差异均有统计学意义(均为P<0.05)。所有患者注射前通过黄斑中心凹的EZ不完整部分的横断面长度为(3116.69±385.55)μm,3次注射后为(1784.88±362.39)μm,差异有统计学意义(P<0.05)。结论 玻璃体内注射康柏西普可以减轻黄斑水肿,提高患者视力,改善黄斑区椭圆体带完整性。
Abstract:
Objective To evaluate the efficacy and safety of intravitreal injection of conbercept for diabetic macular edema (DME) and the changes of ellipsoid zone (EZ).Methods A retrospective study was conducted in 14 patients (16 eyes) and the clinical data were reviewed and analyzed.All the patients were administrated with conbercept intravitreally,and rechecked 1 month,2 months,3 months after injection including the best corrected visual acuity (BCVA) and optical coherence tomography (OCT).Then a comparison was performed in logMAR BCVA,central foveal thickness (CFT) and macular volume before treatment and 1 month,2 months and 3 months after conbercept injection,as well as the cross-sectional length of incomplete portion in EZ before treatment and 3 months after injection.Results The value of logMAR BCVA before treatment and 1 month,2 months and 3 months after conbercept injection was 0.79±0.08,0.65±0.07,0.56±0.06 and 0.52±0.06,respectively;the average CFT before treatment and 1 month,2 months and 3 months after treatment was (536.44±35.87)μm,(385.63±22.60)μm,(336.13±21.91)μm and (292.38±22.54)μm accordingly;the macular volume before treatment and 1 month,2 months and 3 months after treatment was (11.27±0.37)mm3,(10.21±0.22)mm3,(9.69±0.17)mm3 and (9.30±0.20)mm3,respectively,with statistically significance in pairwise comparison.Moreover,the cross-sectional length of disrupted EZ before treatment and 3 months after injection was (3116.69±385.55)μm and (1784.88±362.39) μm respectively,and there was statistically significant difference (P<0.05).Conclusion Intravitreal injection of conbercept to treat DME can alleviate macular edema and restore the disrupted ellipsoid zone.

参考文献/References:

[1] MINAMI Y,NAGAOKA T,ISHIBAZAWA A,YOSHIDA A.Short-term effects of intravitreal ranibizumab therapy on diabetic macular edema[J].BMC Ophthalmol,2017,17(1):28.
[2] HRARAT L,FAJNKUCHEN F,BOUBAYA M,LEVY V,SARDA V,GRENET T,et al.Outcomes after a 1-year treatment with ranibizumab for diabetic macular edema in a clinical setting[J].Ophthalmologica,2016,236(4):207-214.
[3] JOSHI L,BAR A,TOMKINS-NETZER O,YAGANTI S,MORARJI J,VOUZOUNIS P,et al.Intravitreal bevacizumab injections for diabetic macular edema-predictors of response:A retrospective study[J].Clin Ophthalmol,2016,10:2093-2098.
[4] SCARINCI F,JAMPOL LM,LINSENMEIER RA,FAWZI AA.Association of diabetic macular nonperfusion with outer retinal disruption on optical coherence tomography[J].JAMA Ophthalmol,2015,133(9):1036-1044.
[5] AL FARAN A,MOUSA A,AL SHAMSI H,AL GAEED A,GHAZI NG.Spectral domain optical coherence tomography predictors of visual outcome in diabetic cystoid macular edema after bevacizumab injection[J].Retina,2014,34(6):1208-1215.
[6] PIERAMICI DJ,WANG PW,DING B,GUNE S.Visual and anatomic outcomes in patients with diabetic macular edema with limited initial anatomic response to ranibizumab in ride and rise[J].Ophthalmology,2016,123(6):1345-1350.
[7] PRUNTE C,FAJNKUCHEN F,MAHMOOD S,RICCI F,HATZ K,STUDNICKA J,et al.Ranibizumab 0.5 mg treat-and-extend regimen for diabetic macular oedema:The retain study[J].Br J Ophthalmol,2016,100(6):787-795.
[8] CAMPOCHIARO PA,WYKOFF CC,SHAPIRO H,RUBIO RG,EHRLICH JS.Neutralization of vascular endothelial growth factor slows progression of retinal nonperfusion in patients with diabetic macular edema[J].Ophthalmology,2014,121(9):1783-1789.
[9] LI X,XU G,WANG Y,XU X,LIU X,TANG S,et al.Safety and efficacy of conbercept in neovascular age-related macular degeneration:Results from a 12-month randomized phase 2 study:Aurora study[J].Ophthalmology,2014,121(9):1740-1747.
[10] 王琛,李东豪,闻毅颐.玻璃体内注射康柏西普联合周边视网膜选择性光凝治疗视网膜静脉阻塞继发黄斑水肿的疗效及安全性[J].眼科新进展,2016,36(5):471-473.
WANG C,LI DH,WEN YY.Intravitreal injection of conbercept combined with selective peripheral retinal photocoagulation for macular edema secondary to retinal vein occlusion[J].Rec Adv Ophthalmol,2016,36(5):471-473.
[11] 金昱,石安娜,刘淼.玻璃体内注射雷珠单抗(ranibizumab)治疗视网膜静脉阻塞继发黄斑水肿[J].眼科新进展,2014,34(9):855-857.
JIN Y,SHI AN,LIU M.Intravitreal injection of ranibizumab for macular edema secondary to retinal vein occlusion[J].Rec Adv Ophthalmol,2014,34(9):855-857.
[12] 李娜,张杰,高荣玉,孙先勇.单次注射康柏西普治疗渗出型AMD患者RPE隆起面积与容积变化[J].眼科新进展,2016,36(2):172-174.
LI N,ZHANG J,GAO RY,SUN XY.Changes of retinal pigment epithelium uplift area and volume in exudative age-related macular degeneration after once injection of conbercept[J].Rec Adv Ophthalmol,2016,36(2):172-174.
[13] 吴若欣,徐洁慧,温积全,刘健.玻璃体内注射康柏西普对出性老年性黄斑变性患者脉络膜厚度的影响[J].眼科新进展,2016,36(12):1172-1175.
WU RX,XU JH,WEN JQ,LIU J.Effects of intravitreal combercept injections on choroidal thickness in exudative age-related macular degeneration[J].Rec Adv Ophthalmol,2016,36(12):1172-1175.
[14] SCHMIDT-ERFURTH U,LANG GE,HOLZ FG,SCHLINGEMANN RO,LANZETTA P,MASSIN P,et al.Three-year outcomes of individualized ranibizumab treatment in patients with diabetic macular edema:The restore extension study[J].Ophthalmology,2014,121(5):1045-1053.
[15] SUGIMOTO M,ICHIO A,NUNOME T,KONDO M.Two year result of intravitreal bevacizumab for diabetic macular edema using treat and extend protocol[J].Medicine (Baltimore),2017,96(16):e6406.
[16] LEE SJ,KIM ET,MOON YS.Intravitreal bevacizumab alone versus combined with macular photocoagulation in diabetic macular edema[J].Korean J Ophthalmol,2011,25(5):299-304.
[17] JAVANOVIC S,CANADANOVIC V,SABO A,GRGIC Z,MITROVIC M,RAKIC D.Intravitreal bevacizumab injection alone or combined with macular photocoagulation compared to macular photocoagulation as primary treatment of diabetic macular edema[J].Vojnosanit Pregl,2015,72(10):876-882.
[18] XU Y,RONG A,BI Y,XU W.Intravitreal conbercept injection with and without grid laser photocoagulation in the treatment of diffuse diabetic macular edema in real-life clinical practice[J].J Ophthalmol,2016,2016:2143082.
[19] BROWN DM,NGUYEN QD,MARCUS DM,BOYER DS,PATEL S,FEINER L,et al.Long-term outcomes of ranibizumab therapy for diabetic macular edema:The 36-month results from two phase iii trials:Rise and ride[J].Ophthalmology,2013,120(10):2013-2022.
[20] NGUYEN QD,BROWN DM,MARCUS DM,BOYER DS,PATEL S,FEINER L,et al.Ranibizumab for diabetic macular edema:Results from 2 phase iii randomized trials:Rise and ride[J].Ophthalmology,2012,119(4):789-801.
[21] NAKAMURA Y,TAKEDA N,TATSUMI T,OSHITARI T,ARAI M,TAKATSUNA Y,et al.Macular ischemia following intravitreal bevacizumab therapy for diabetic macular edema[J].Nippon Ganka Gakkai Zasshi,2012,116(2):108-113.
[22] KIIRE CA,MORJARIA R,RUDENKO A,FANTATO A,SMITH L,SMITH A,et al.Intravitreal pegaptanib for the treatment of ischemic diabetic macular edema[J].Clin Ophthalmol,2015,9:2305-2311.
[23] MURAKAMI T,YOSHIMURA N.Structural changes in individual retinal layers in diabetic macular edema[J].J Diabetes Res,2013,2013:920713.
[24] SONODA S,SAKAMOTO T,YAMASHITA T,SHIRASAWA M,OTSUKA H,SONODA Y.Retinal morphologic changes and concentrations of cytokines in eyes with diabetic macular edema[J].Retina,2014,34(4):741-748.
[25] MURAKAMI T,NISHIJIMA K,AKAGI T,UJI A,HORII T,UEDA-ARAKAWA N,et al.Optical coherence tomographic reflectivity of photoreceptors beneath cystoid spaces in diabetic macular edema[J].Invest Ophthalmol Vis Sci,2012,53(3):1506-1511.
[26] SPAIDE RF,CURCIO CA.Anatomical correlates to the bands seen in the outer retina by optical coherence tomography:Literature review and model[J].Retina,2011,31(8):1609-1619.
[27] STAURENGHI G,SADDA S,CHAKRAVARTHY U,SPAIDE RF,INTERNATIONAL NOMENCLATURE FOR OPTICAL COHERENCE TOMOGRAPHY P.Proposed lexicon for anatomic landmarks in normal posterior segment spectral-domain optical coherence tomography:The IN*OCT consensus[J].Ophthalmology,2014,121(8):1572-1578.
[28] TOPRAK I,YAYLALI V,YILDIRIM C.Early deterioration in ellipsoid zone in eyes with non-neovascular age-related macular degeneration[J].Int Ophthalmol,2017,37(4):801-806.
[29] HASEBE H,MATSUOKA N,TERASHIMA H,SASAKI R,UEDA E,FUKUCHI T.Restoration of the ellipsoid zone and visual prognosis at 1 year after surgical macular hole closure[J].J Ophthalmol,2016,2016:1769794.

相似文献/References:

[1]杜玮 刘子扬 周艳艳 雒雷鸣.糖尿病视网膜病变与血清胆红素水平的关系[J].眼科新进展,2012,32(5):000.
[2]范松涛 卢建民.阿司匹林与糖尿病患者玻璃体出血以及玻璃体切割术疗效的相关性研究[J].眼科新进展,2012,32(11):000.
[3]李艳 李筱荣 袁佳琴 潘斌.糖尿病大鼠视网膜中VEGF、PEDF的表达与血-视网膜屏障损伤[J].眼科新进展,2013,33(1):000.
[4]李朝晖 崔治华 胡晓英 孟丽珠 张敬维.糖尿病视网膜病变激光面积与疗效的分析[J].眼科新进展,2013,33(2):000.
[5]冯冬梅 朱鸿 施彩虹.CXC趋化因子及其受体在糖尿病视网膜病变中的作用[J].眼科新进展,2013,33(6):000.
[6]牛淑玲.糖尿病视网膜病变患者HbAlc、FPG与血小板参数的变化及危险因素分析[J].眼科新进展,2013,33(7):000.
[7]毕春潮 王睿 王建洲 雷春灵 董晓娟 王小莉 薛晓辉.Ad-PEDF对糖尿病视网膜病变大鼠视网膜新生血管的抑制作用[J].眼科新进展,2013,33(8):000.
[8]杨萍 孙书明 李晓鹏.辛伐他汀对糖尿病视网膜病变和炎症因子的影响[J].眼科新进展,2013,33(8):000.
[9]罗文婷 孙大卫.血管黏附蛋白-1在眼科疾病中的研究进展[J].眼科新进展,2013,33(8):000.
[10]李小璐 马雅玲.糖尿病视网膜病变大鼠视网膜VEGF和PEDF的动态表达[J].眼科新进展,2013,33(9):000.
[11]鲁丹 王康 王艳玲 林鹏耀 李茜 李明铭.后Tenon囊下注射曲安奈德辅助全视网膜光凝治疗糖尿病视网膜病变[J].眼科新进展,2013,33(5):000.
[12]陈素芳 曾莉 邵毅. 非诺贝特在糖尿病视网膜病变中的应用进展[J].眼科新进展,2014,34(3):283.
[13]魏光杰,何佃菊.532nm绿激光格栅样光凝联合球内注药治疗糖尿病视网膜病变黄斑水肿[J].眼科新进展,2014,34(8):779.[doi:10.13389/j.cnki.rao.2014.0215]
 WEI Guang-Jie,HE Dian-Ju.532 run green grid laser photocoagulation combined with intravitreal Avastin injection for diabetic retinopathy macular edema[J].Recent Advances in Ophthalmology,2014,34(11):779.[doi:10.13389/j.cnki.rao.2014.0215]
[14]朱岩,汪军,孟忻,等. 非增殖期糖尿病视网膜病变黄斑水肿对脉络膜横断面面积的影响[J].眼科新进展,2015,35(7):683.[doi:10.13389/j.cnki.rao.2015.0187]
 ZHU Yan,WANG Jun,MENG Xin,et al. Effects of macular edema on choroidal cross sec on area in non-proliferative diabetic retinopathy[J].Recent Advances in Ophthalmology,2015,35(11):683.[doi:10.13389/j.cnki.rao.2015.0187]
[15]徐静,唐晓娟,于健,等.糖尿病黄斑水肿患者病变程度与脉络膜厚度的关系[J].眼科新进展,2019,39(5):444.[doi:10.13389/j.cnki.rao.2019.0102]
 XU Jing,TANG Xiao-Juan,YU Jian,et al.Comparisons of choroidal thickness in relation to macular edema in type 2 diabetic patients[J].Recent Advances in Ophthalmology,2019,39(11):444.[doi:10.13389/j.cnki.rao.2019.0102]
[16]雷祥,范珂,崔红培,等.不同类型视网膜病变患者视网膜外层厚度变化研究[J].眼科新进展,2019,39(6):536.[doi:10.13389/j.cnki.rao.2019.0123]
 LEI Xiang,FAN Ke,CUI Hong-Pei,et al.Changes in outer retinal thickness in patients with different types of retinopathy[J].Recent Advances in Ophthalmology,2019,39(11):536.[doi:10.13389/j.cnki.rao.2019.0123]
[17]陈若瑜,曹丹,张良.糖尿病视网膜病变药物治疗研究进展[J].眼科新进展,2022,42(3):244.[doi:10.13389/j.cnki.rao.2022.0050]
 CHEN Ruoyu,CAO Dan,ZHANG Liang.Advances in drug therapy for diabetic retinopathy[J].Recent Advances in Ophthalmology,2022,42(11):244.[doi:10.13389/j.cnki.rao.2022.0050]
[18]郑雨薇,蒋正轩,李恒,等.2型糖尿病患者干眼相关指标分析[J].眼科新进展,2022,42(11):874.[doi:10.13389/j.cnki.rao.2022.0180]
 ZHENG Yuwei,JIANG Zhengxuan,LI Heng,et al.Analysis of dry eye related factors in type 2 diabetic patients[J].Recent Advances in Ophthalmology,2022,42(11):874.[doi:10.13389/j.cnki.rao.2022.0180]
[19]朱婷婷,黄丹,张春元,等.玻璃体内注射康柏西普对糖尿病黄斑水肿患者和继发于视网膜静脉阻塞的黄斑水肿患者的疗效差异[J].眼科新进展,2023,43(1):053.[doi:10.13389/j.cnki.rao.2023.0011]
 ZHU Tingting,HUANG Dan,ZHANG Chunyuan,et al.Different efficacies of intravitreal injection of conbercept for diabetic macular edema and macular edema secondary to retinal vein obstruction[J].Recent Advances in Ophthalmology,2023,43(11):053.[doi:10.13389/j.cnki.rao.2023.0011]

更新日期/Last Update: 2017-11-01