摘要目的 观察玻璃体腔注射康柏西普治疗特发性脉络膜新生血管(ICNV)的临床疗效.方法 前瞻性、无对照、开放性研究.经最佳矫正视力(BCVA)、眼压、间接检眼镜、眼底彩色照相、荧光素眼底血管造影(FFA)及光相干断层扫描(OCT)检查确诊为ICNV的11例患者12只眼纳入研究.采用糖尿病视网膜病变早期治疗研究视力表检查BCVA,OCT测量中心视网膜厚度(CRT).患眼治疗前BCVA为25～77个字母,平均字母数(61.73±14.58)个;CRT为290～467 μm,平均CRT为(330.73±47.79) μm.所有患眼玻璃体腔注射10 mg/ml的康柏西普0.05 ml(含康柏西普0.5 mg).第1次注射后每一个月随访1次,根据随访情况决定是否重复治疗.患眼平均注射次数(1.91±1.04)次.平均随访时间(6.73±1.19)个月.12只眼中,完成整个随访11只眼,失访1只眼.对比分析治疗前后患眼BCVA、CRT及脉络膜新生血管(CNV)病灶渗漏变化,同时观察随访期间眼部与全身不良反应发生情况.结果 治疗后1、3、6个月,患眼平均BCVA均较治疗前提高,差异有统计学意义(t=2.68、3.80、3.65,P＜0.05).治疗后1个月,视力显著提高、提高、稳定、降低分别为1、8、1、1只眼,分别占患眼的9.09％、72.73％、9.09％、9.09％.治疗后6个月,视力显著提高、提高、稳定、降低分别为3、6、1、1只眼,分别占患眼的27.27％、54.55％、9.09％、9.09％.治疗后1、3、6个月,患眼平均CRT均较治疗前降低,差异有统计学意义(t=2.44、3.78、4.12,P＜0.05).治疗后6个月,FFA检查发现,CNV病灶渗漏消失、渗漏减轻及渗漏扩大分别为6、3、2只眼,分别占患眼的58.33％、25％、16.67％.OCT检查发现,所有患眼视网膜水肿消退,中心凹形态正常.随访期间未见视网膜脱离、视网膜撕裂、眼压持续升高、眼内炎等与治疗相关的眼部并发症和全身不良反应发生.结论 玻璃体腔注射康柏西普治疗ICNV可提高患眼视力,降低患眼CRT,减轻CNV病灶渗漏;无与治疗相关的不良反应发生.

abstractsObjective To observe the clinical efficacy of intravitreal Conbercept on idiopathic choroidal neovascularization (ICNV).Methods This is an open and prospective study without control trial.Twelve eyes from 11 patients (7 females and 4 males) with ICNV diagnosed by best corrected visual acuity (BCVA),noncontact tonometer,ophthalmoscope,fundus photography,optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) were enrolled in this study.All affected eyes were treated with intravitreal Conbercept 0.05 ml (10 mg/ml) and received an average of (1.91±1.04) injections.The initial average letters of Early Treatment Diabetic Retinopathy Study (ETDRS) chart acuity were 61.73[14.58,range from 25 to 77.The patients were followed up for 6 to 9 months.The initial average central retinal thickness (CRT) was (330.73 ± 47.79) μm,range from 290 to 467 μm.Best-corrected visual acuity (BCVA),OCT and ophthalmoscope examination were assessed monthly.Results During the 1,3,6 months after treatment,themean BCVA were all improved with statistically significant difference (t=2.68,3.80,3.65;P＜0.05).At 1 month later after treatment,the mean BCVA was obviously improved in 1 eye (9.09％),improved in 8 eyes (72.73％),stable in 1 eye (9.09％),decreased in 1 eye (9.09％).At 6 month later after treatment,the mean BCVA was obviously improved in 3 eyes (27.27％),improved in 6 eyes (54.55％),stable in 1 eye (9.09％),decreased in 1 eye (9.09 ％).During the 1,3,6 months after treatment,the mean CRT were all decreased with statistically significant difference(t=2.44,3.78,4.12;P＜0.05).At latest follow up,the leakage in macula luteadisappearedin6 eyes(58.33％),decreased in 11 eyes (25％)and increased in 3 eyes (16.67％).There were no systemic or ocular serious side effects during the follow up.Conclusion Intravitreal Conbercept for ICNV showed CNV regression,retinal thickness reduction,visual acuity improvement and safety.