【摘要】 目的观察玻璃体内注射康柏西普联合多波长激光光凝治疗Coats病的临床疗效。方法前瞻性分析2015年1月至2019年12月,Coats病患者39例39只眼纳的临床资料。随机分为两组,A组采用玻璃体注射康柏西普后1周,再行多波长激光光凝治疗;B组仅行多波长激光光凝治疗。两组激光光凝参数:后极部光斑直径100μm,曝光时间80～150 ms,功率80～150 m W,光斑强度为Ⅰ～Ⅱ级光斑反应;周边部光斑直径200μm,曝光时间200～300 ms,功率150～300m W,光斑强度为Ⅱ～Ⅲ级光斑反应。完成病灶区域光凝后1、3和6个月检测最佳矫正视力(best-corrected visual acuity,BCVA)改变,并进行眼底荧光素血管造影(fundus fluorescein angiography,FFA)观察血管情况、光学相干断层成像术(optical coherence tomography,OCT)检测黄斑水肿。并记录两组激光光凝次数和不良反应发生情况。结果 (1)两组BCVA情况:A组治疗后1和3个月较治疗前BCVA提高(P<0.05),B组治疗后1个月、3个月BCVA较治疗前差异无统计学意义(P>0.05);两组治疗后6个月BCVA较治疗前均有提高(P<0.05),两组间BCVA比较差异无统计学意义(P>0.05)。(2)两组患者治疗后CMT均低于治疗前(P<0.05),A组CMT低于B组(P<0.05)。(3)治疗次数比较:A组的激光光凝次数为(3.53±1.2)次,少于B组(4.05±1.5)次(P<0.05)。(4)FFA检测情况:两组治疗后复查FFA血管渗漏减少,两组间差异无统计学意义(P>0.05)。(5)并发症情况:A组治疗后5例出现小片结膜下出血,1～2周后自行吸收。两组均未出现眼部症状加重及全身不良反应。结论康柏西普联合多波长激光光凝或单纯多波长激光光凝治疗Coats病均有明确疗效,联合治疗恢复更快。更多还原

【Abstract】 Objective To observe the clinical efficacy to treat Coats disease jointly with intravitreal injection of conbercept and multi-wavelength laser photocoagulation.Methods This was a prospective study.Totally 39 patients(39 eyes) of Coats disease treated during the period from Jan.2015 to Dec.2019 were selected and randomly divided into two groups:group A in which the patients were given conbercept plus multiwavelength laser photocoagulation,and group B,in which the patients were given only multi-wavelength laser photocoagulation.The efficacy of the two groups was observed.Results (1)Changes of BCVA:The BCVA was higher 1 and 3 months after the treatment than that before the treatment in group A(P<0.05).As to group B,the differences were not significant(P>0.05).The BCVA increased in both groups 6 months after the treatment(P<0.05),and the difference between the two groups was not significant(P>0.05).(2) Changes of CMT:After the treatment,the CMT of both groups was lower than that before the treatment(P<0.05).The CMT was lower in group A than in group B(P<0.05).(3) Comparison of the number of treatments.The number of laser photocoagulation was 3.53±1.2 in the combined treatment group and 4.05±1.5 times in the simple laser group,and the difference was statistically significant(P<0.05).(4) FFA detection:After the treatment,FFA vascular leakage decreased in both groups,and there was no significant difference between the two groups(P>0.05).(5) Complications:In group A,5 patients had subconjunctival hemorrhage,which disappeared 1-2 weeks later via self-absorption.Neither ocular symptom aggravation nor systemic adverse reaction occurred in either group.Conclusions Both the combination of conbercept with multi-wavelength laser photocoagulation and simple multi-wavelength laser photocoagulation are effective in treating Coats disease,but the combined treatment will bring in faster and better recovery.更多还原