[1]李凤媚,宋艳萍.康柏西普玻璃体内重复注射治疗息肉状脉络膜血管病变疗效及相关因素分析[J].眼科新进展,2019,39(10):969-972.[doi:10.13389/j.cnki.rao.2019.0221]
 LI Feng-Mei,SONG Yan-Ping.Efficacy of intravitreal injection of conbercept in polypoidal choroidal vasculopathy and its related factors[J].Recent Advances in Ophthalmology,2019,39(10):969-972.[doi:10.13389/j.cnki.rao.2019.0221]
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康柏西普玻璃体内重复注射治疗息肉状脉络膜血管病变疗效及相关因素分析/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
39卷
期数:
2019年10期
页码:
969-972
栏目:
应用研究
出版日期:
2019-10-05

文章信息/Info

Title:
Efficacy of intravitreal injection of conbercept in polypoidal choroidal vasculopathy and its related factors
作者:
李凤媚宋艳萍
430070 湖北省武汉市,南方医科大学武汉临床医学院、中国人民解放军武汉总医院全军眼科中心
Author(s):
LI Feng-MeiSONG Yan-Ping
Wuhan Clinical School of Medicine,Southern Medical University,Ophthalmic Center of Wuhan General Hospital of the Chinese People’s Liberation Army,Wuhan 430070,Hubei Province,China
关键词:
息肉状脉络膜血管病变血管内皮生长因子最佳矫正视力视网膜色素上皮脱离浆液性视网膜脱离
Keywords:
polypoidal choroidal vasculopathyvascular endothelial growth factorbest corrected visual acuityretinal epithelial detachmentserous retinal detachment
分类号:
R773.4
DOI:
10.13389/j.cnki.rao.2019.0221
文献标志码:
A
摘要:
目的 观察康柏西普玻璃体内重复注射治疗息肉状脉络膜血管病变(polypoidal choroidal vasculopathy,PCV)随访24个月的疗效及第13~24个月需要进行重复注射的相关因素。方法 回顾性研究。将临床确诊为PCV的35例35眼患者纳入研究,所有患者均行最佳矫正视力(best corrected visual acuity,BCVA)、眼底彩色照相、荧光素眼底血管造影、吲哚菁绿血管造影和光学相干断层扫描(optical coherence tomography,OCT)检查。所有患眼均采用每月注射1次、连续注射3个月后按需治疗的方案行康柏西普玻璃体内注射治疗。随访时间均在24个月以上。治疗后 1个月、2个月、3个月、6个月、9个月、12个月、24个月重复行BCVA及OCT检查;治疗后 3个月、6个月、9个月、12个月、24个月重复行荧光素眼底血管造影及吲哚菁绿血管造影检查。对比治疗前后BCVA、黄斑中心凹视网膜厚度及浆液性视网膜脱离(serous retinal detachment,SRD)、息肉消退的变化,并分析随访第13~24个月需要进行重复注射的相关因素。结果 治疗后 1个月、2个月、3个月、6个月、9个月、12个月、24个月患眼BCVA均较治疗前有不同程度提高,差异均有统计学意义(均为P<0.05);黄斑中心凹视网膜厚度较治疗前有不同程度下降,差异均有统计学意义(均为P<0.001)。Logistic回归分析显示,基线视网膜色素上皮脱离是第13~24个月需要进行重复注射的独立相关因素(P=0.042),治疗后6个月、9个月、12个月 SRD与第13~24个月需要重复注射相关(P=0.043、0.023、0.012)。结论 康柏西普玻璃体内重复注射治疗PCV随访24个月能稳定或提高视力,基线视网膜色素上皮脱离和治疗后6个月、9个月、12个月SRD是第13~24个月需要进行重复注射的相关因素。
Abstract:
Objective To observe the efficacy of conbercept in the treatment of polypoidalchoroidalvasculopathy (PCV) patients for 24 months follow-up and to analyze the its related factors of retreatment from 13 months to 24 months.Methods A retrospective study.Thirty-five eyes of 35 patients with PCV were enrolled into this study.All patients underwent best corrected visual acuity (BCVA),fundus color photography,fundus fluorescein angiography,indocyanine green angiography and optical coherence tomography (OCT).These patients received three initial intravitreal injection of conbercept (IVC) monthly and were retreated with IVC when needed.All patients were followed up for more than 24 months.On 1 month,2,3,6,9,12,and 24 months after treatment,BCVA and OCT examinations were repeated.On 3,6,9,12 and 24 months after treatment,FFA and ICGA examinations were conducted.The changes of BCVA,central retinal thickness (CRT),serous retinal detachment (SRD) and the regression of polyps were observed.The related factors of retreatment from 13 months to 24 months were analyzed.Results On 1 month,2,3,6,12 and 24 months after treatment,the BCVA improved significantly (all P<0.05),the CRT were decreased significantly (all P<0.001).Logistic regression analysis showed the absence of retinal epithelial detachment (RPED) at baseline was a independent factor for requiring retreatment from 13 months to 24 months (P=0.042).SRD at 6 months,9 months,and 12 months after treatment was associated with repeated injections at 13 to 24 months (P=0.043,0.023,0.012).Conclusion Visual outcomes of PCV patients treated with conbercept improve.RPED at baseline and SRD development during follow-up are related factors for the repeated injections of conbercept from 13 months to 24 months.

参考文献/References:

[1] YANNUZZI L A,SORENSON J,SPAIDE R F,LIPSON B.Idiopathic polypoidal choroidal vasculopathy (IPCV)[J].Retina,1990,10(1):1-8.
[2] IMAMURA Y,ENGELBERT M,IIDA T,FREUND K B,YANNUZZI L A.Polypoidal choroidal vasculopathy:a review[J].Surv Ophthalmol,2010,55(6):501-515.
[3] UYAMA M,WADA M,NAGAI Y,MATSUBARA T,MATSUNAGA H,FUKUSHIMA I,et al.Polypoidal choroidal vasculopathy:natural history[J].Am J Ophthalmol,2002,133(5):639-648.
[4] KIKUSHIMA W,SAKURADA Y,SUGIYAMA A,TANABE N,MATSUBARA M,MABUCHI F,et al.Comparison of two-year outcomes after photodynamic therapy with ranibizumab or aflibercept for polypoidal choroidal vasculopathy[J].Sci Rep,2017,7(1):16461.
[5] KIKUSHIMA W,SAKURADA Y,SUGIYAMA A,TANABE N,KUME A,LIJIMA H,et al.Comparison of initial treatment between 3-monthly intravitreal aflibercept monotherapy and combined photodynamic therapy with single intravitreal aflibercept for polypoidal choroidal vasculopathy[J].Graefes Arch Clin Exp Ophthalmol,2017,255(2):311-316.
[6] MORI R,YUZAWA M,AKAZA E,HARUYAMA M.Treatment results at 1 year of ranibizumab therapy for polypoidal choroidal vasculopathy in eyes with good visual acuity[J].Jpn J Ophthalmol,2013,57(4):365-371.
[7] LALWANI G A,ROSENFELD P J,FUNG A E,DUBOVY S R,MICHELS S,FEUER W,et al.A variable-dosing regimen with intravitreal ranibizumab for neovascular age-related macular degeneration:year 2 of the Pronto Study[J].Am J Ophthalmol,2009,148(1):43-58.
[8] NAKANISHI H,YAMASHIRO K,YAMADA R,GOTOH N,HAYASHI H,NAKATA I,et al.Joint effect of cigarette smoking and CFH and LOC387715/HTRA1 polymorphisms on polypoidal choroidal vasculopathy[J].Invest Ophthalmol Vis Sci,2010,51(12):6183-6187.
[9] TONG J P,CHAN W M,LIU D T,LAI T Y,CHOY K W,PANG C P,et al.Aqueoushumor levels of vascular endothelial growth factor and pigment epithelium-derived factor in polypoidal choroidal vasculopathy and choroidal neovascularization[J].Am J Ophthalmol,2006,141(3):456-462.
[10] KOKAMO G T,YEUNG L,TERAMOTO K,LAI J C,WEE R.Polypoidal choroidal vasculopathy exudation and hemorrhage:results of monthly ranibizumab therapy at one year[J].Ophthalmologica,2014,231(2):94-102.
[11] KOKAMO G T,YEUNG L,LAI J C.Continuous anti-VEGF treatment with ranibizumab for polypoidal choroidal vasculopathy:6-month results[J].Br J Ophthalmol,2010,94(3):297-301.
[12] MATSUOKA M,OGATA N,OTSUJI T,NISHIMURA T,TAKAHASHI K,MATSUMURA M,et al.Expression of pigment epithelium derived factor and vascular endothelial growth factor in choroidal neovascular membranes and polypoidal choroidal vasculopathy[J].Br J Ophthalmol,2004,88(6):809-815.
[13] NG E W,ADAMIS A P.Targeting angiogenesis,the underlying disorder in neovascular age-related macular degeneration[J].Can J Ophthalmol,2005,40(3):352-368.
[14] CAMPOCHIARO P A,HAFIZ G,MIR T A,SCOTT A W,SOLOMON S,ZIMMER-GALLER I,et al.Scatter photocoagulation does not reduce macular edema or treatment burden in patients with retinal vein occlusion:The RELATE Trial[J].Ophthalmology,2015,122(7):1426-1437.
[15] CHEUNG C M,LAI T Y,CHEN S J,CHONG V,LEE K,HTOON H,et al.Understanding indocyanine green angiography in polypoidal choroidal vasculopathy:the group experience with digital fundus photography and confocal scanning laser ophthalmoscopy[J].Retina,2014,34(12):2397-2406.
[16] CHO H J,KIM J W,LEE D W,CHO S W,KIM C G.Intravitreal bevacizumab and ranibizumab injections for patients with polypoidal choroidal vasculopathy[J].Eye (Lond),2012,26(3):426-433.
[17] INOUE M,ARAKAWA A,YAMANE S,KADONOSONO K.Short-term efficacy of intravitreal aflibercept in treatment-naive patients with polypoidal choroidal vasculopathy[J].Retina,2014,34(11):2178-2184.
[18] QU J,CHENG Y,LI X,YU L,KE X.Efficacy of intravitreal injection of conbercept in polypoidal choroidal vasculopathy:Subgroup Analysis of the Aurora Study[J].Retina,2016,36(5):926-937.
[19] KOIZUMI H,YAMAGISHI T,YAMAZAKI T,KINOSHITA S.Predictive factors of resolved retinal fluid after intravitreal ranibizumab for polypoidal choroidal vasculopathy[J].Br J Ophthalmol,2011,95(11):1555-1559.
[20] CHAN E W,ELDEEB M,LINGAM G,THOMAS D,BHARGAVA M,CHEE C K,et al.Quantitative changes in pigment epithelial detachment area and volume predict retreatment in polypoidal choroidal vasculopathy[J].Am J Ophthalmol,2017,177(2):195-205.

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更新日期/Last Update: 2019-10-12