玻璃体腔注射不同抗VEGF药物治疗NVG的疗效观察
1. 铜仁市人民医院, 眼科, 贵州铜仁 554300
2. 中国人民解放军中部战区总医院, 眼科, 湖北武汉 430070
| 摘 要： | 目的：探讨玻璃体腔内注射不同抗血管内皮生长因子（Vascular endothelial growth factor, VEGF）药物康柏西普或雷珠单抗联合青光眼Ex-Press引流钉植入及全视网膜光凝术治疗新生血管性青光眼（neovascular glaucoma, NVG）的临床疗效。方法：选择2018.01-2020.12在中国人民解放军中部战区总医院眼科就诊60名新生血管性青光眼患者为研究对象，行青光眼Ex-Press引流钉植入及全视网膜光凝术，术前7天均行玻璃体腔注射雷珠单抗或康柏西普，按照随机数字抽签法，分为雷珠单抗组、康柏西普组，每组各30例30只眼，比较两组治疗效果，最佳矫正视力、眼压、新生血管消退情况及并发症。结果：治疗后两组各个时间点眼压均低于术前（P<0.05），治疗后7天、1个月、3个月，康柏西普组患者的眼压降低幅度及视力改善均优于雷珠单抗组（P<0.05）。治疗12个月，康柏西普组，雷珠单抗组治疗总成功率分别为56.67%，53.33%（P>0.05），并发症发生率分别为26.67%，36.67%（P>0.05）。治疗6个月、12个月眼压降低幅度及视力改善方面两组无差异（P>0.05）。结论：玻璃体腔注射康柏西普或雷珠单抗联合青光眼Ex-Press引流钉植入及全视网膜光凝术治疗NVG疗效确切，短期内康柏西普组降眼压效果，视力恢复方面优于雷珠单抗组。 |
| 关 键 词： | 新生血管性青光眼; 康柏西普; 雷珠单抗; 玻璃体腔注射 |
| DOI： | 10.57237/j.cmf.2023.03.001 |
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收稿日期: 2023-07-14
接受日期: 2023-10-07
在线出版日期: 2023-10-09
Clinical Efficacy of Intravitreal Different VEGF in Patient with Neovascular Glaucoma
1. Department of Ophthalmology, The People's Hospital, Tongren 554300, China
2. Department of Ophthalmology, Central War Zone General Hospital of the Chinese People's Liberation Army, Wuhan 430070, China
| Abstract: | Objective: To investigate the clinical efficacy of intravitreal Conbercept or Lucentis combined with Ex-Press drain implantation and panretina photocoagnlation in patient with neovascular glaucoma. Methods: A total of 60 patients (60 eyes) diagnosed with NVG from Jan. 2018 to Dec. 2020 were enrolled as the study subjects, who underwent glaucoma Ex-press drainage implantation and PRP, and intravitreal Conbercept or Lucentis 3 days before surgery. According to the random number lottery method, the patients were randomized into two groups, Conbercept group and Lucentis group, with 30 cases and 30 eyes in each group. The treatment effect for best corrected visual acuity (BCVA), intraocular pressure (IOP), status of neovascularization and complications incidence were compared between the two groups. Results: the IOP levels of patients in both groups were significantly reduced compared to those before surgery (P>0.05). At 7 days, 1 month and 3 months after treatment, IOP reduction and BCVA improvement in Conbercept group were better than those in Lucentis group (P<0.05). After 12 months of treatment, the overall success rate of the Conbercept group and the Lucentis group were 56.67% and 53.33%, respectively (P>0.05), and the complication rate was 26.67% and 36.67%, respectively (P>0.05). There was no difference in IOP reduction and BCVA improvement between the two groups at 6 and 12 months of treatment (P>0.05). Conclusion: The Clinical efficacy of intravitreal Conbercept or Lucentis combined with Ex-Press drain implantation and PRP in patient with neovascular glaucoma is definite. The short-term effect of IOP reduction and visual recovery in the Conbercept group is better than that in the Lucentis group. |
| Keywords: | Neovascular Glaucoma; Conbercept; Lucentis; Intravitreal |
参考文献
| [1] | Senthil S, Dada T, Das T, et al. Neovascular glaucoma - A review. Indian J Ophthalmol. 2021 Mar; 69(3): 525-534. |
| [2] | WEISS D, SHAFFER R, NEHRENBERG T. Neovascular gluacoma complicating carotid-cavernous fistula. Arch. Ophthalmol. 1963; 69: 304-307. |
| [3] | 中华医学会眼科学分会青光眼学组. 中国新生血管性青光眼诊疗专家共识 (2019年). 中华眼科杂志. 2019; 55(11): 814-817. |
| [4] | 中华医学会眼科学分会青光眼学组. 我国房水流出通路重建术专家共识 (2017年). 中华眼科杂志, 2017, 53(3): 167-169. |
| [5] | 中华医学会眼科学分会青光眼学组, 中国医师协会眼科医师分会青光眼学组. 中国青光眼指南 (2020年). 中华眼科杂志, 2020, 56(8): 573-586. |
| [6] | Dumbrăveanu L, Cușnir V, Bobescu D. A review of neovascular glaucoma. Etiopathogenesis and treatment Rom J Ophthalmol. 2021 Oct-Dec; 65(4): 315-329. |
| [7] | Bai L, Wang Y, Liu X, et al. The Optimization of an Anti-VEGF Therapeutic Regimen for Neovascular Glaucoma. Front Med (Lausanne). 2022 Jan 10; 8: 766032. |
| [8] | Chen S, Zhou M, Wang W, et al. Levels of angiogenesis related vascular endothelial growth factor family in neovascular glaucoma eyes Acta Ophthalmologica, 2015, 93(7): e556-60. |
| [9] | Shi L, Yang J, Lin J. What is the impact of intravitreal injection of conbercept on neovascular glaucoma patients: a prospective, interventional case series study. BMC Ophthalmol. 2019; 19(1): 128-128. |
| [10] | Zoya Rabkin-Mainer, Alvit Wolf, Nurit Mathalone, et al. Ex-PRESS Miniature Glaucoma Shunt Versus Ahmed Glaucoma Valve in the Surgical Treatment of Glaucoma in Pseudophakic Patients. J Glaucoma. 2018 Oct; 27(10): 887-892. |
| [11] | Bo W, Da D, Sun F. Observation of curative effects of ex-PRESS and AGV implantation in the treatment of refractory glaucoma (Article). Experimental and Therapeutic Medicine. 2018 (No. 5): 4419-4425. |
| [12] | 孔繁学, 马翔, 范松涛, 等. 玻璃体腔注射雷珠单抗和康柏西普联合青光眼引流阀植入治疗新生血管性青光眼的疗效．吉林大学学报 (医学版). 2017; 43(6): 1237-1242. |
| [13] | Li P, Liu Q, Liu XM, et al. Clinical research of EX-PRESS drainage device and modified trabeculectomy combined with intravitreal conbercept treatment for neovascular glaucoma. Int J Ophthalmol. 2022 Feb 18; 15(2): 242-247. |
| [14] | Kawabata K, Shobayashi K, Iwao K, et al. Efficacy and safety of Ex-PRESS® mini shunt surgery versus trabeculectomy for neovascular glaucoma: a retrospective comparative study. BMC Ophthalmology (BMC OPHTHALMOL). 2019 (No. 1). |
| [15] | 赵媛, 余敏, 代艳, 等. 康柏西普联合 EX－PＲESS 青光眼引流器植入对 NVG 患者视力及并发症的影响. 国际眼科杂志 2020; 20(10): 1809－1813. |
| [16] | 牛童童, 邓月, 刘毅, 等. 康柏西普联合不同手术方式对新生血管性青光眼疗效观察 [J]. 国际眼科杂志, 2021, 21(11): 1865-1869. |
