糖尿病视网膜病变玻璃体腔注射康柏西普后视网膜内层结构紊乱变化的相关性分析

Correlation Analysis of Disorganization of Retinal Inner Layers after Intravitreal Injection of Conbercept in Diabetic Retinopathy

摘要: 目的：观察糖尿病视网膜病变(DR)患者规律接受抗血管内皮生长因子(VEGF)药物后视网膜内层结构紊乱(DRIL)的变化，分析DRIL与视功能的相关性，以及抗VEGF药物对DRIL的影响。方法：前瞻性研究。将2021-10/2022-10我院收治的DR患者23例30只眼作为研究对象。患眼均行3 + PRN玻璃体腔注射康柏西普治疗，以6个月为随访时间。治疗前根据黄斑区直径1 mm内DRIL长度将患眼分为DRIL ≤ 500 μm组和 DRIL > 500 μm组。对比分析2组患者治疗前资料的差异，以及最佳矫正视力(BCVA)、DRIL长度、中心凹视网膜厚度(CMT)、椭圆体带(EZ)断裂长度等参数在治疗前后的差异，分析治疗后1、3、6个月DRIL与BCVA、CMT、ZE断裂长度的相关性。结果：DRIL长度、CMT和EZ断裂长度在治疗前两组患者中存在差异(P < 0.05)，治疗后1、3、6个月BCVA、DRIL长度、CMT和EZ断裂长度在治疗后与治疗前相比(P < 0.05)均有改善。且DRIL ≤ 500 μm组的指标改善程度优于DRIL > 500 μm组(P < 0.05)。Spearman秩相关检验方法显示，治疗1、3、6个月的随访中DRIL与logMAR BCVA呈相关性(r = 0.556、0.576、0.461, P < 0.05)，并且相较于CMT和EZ断裂长度而言，相关性更强，且均为正相关。结论：玻璃体腔内注射抗VEGF药物康柏西普可以改善DR患者DRIL。DRIL相较CMT及EZ与视功能的关联性更强，可能是BCVA改善的预测因素。

Abstract: AIM: The changes of disorganization of retinal inner layers (DRIL) in patients with diabetic reti-nopathy (DR) after regular reception of anti-vascular endothelial growth-factor (VEGF) drugs were observed, and the correlation between DRIL and visual function and the effect of anti-VEGF drugs on DRIL were analyzed. Methods: A prospective study was conducted. 23 cases of 30 eyes of DR pa-tients admitted to our hospital in 2021-10/2022-10 were used as research subjects. The affected eye was treated with 3 + PRN intravitreal injection Conbercept, and the follow-up time was 6 months. Before treatment, the affected eye was divided into DRIL ≤ 500 μm group and DRIL > 500 μm group according to the length of DRIL within 1 mm diameter of the macular area. The differ-ences in pre-injection data and the differences in best-corrected visual acuity (BCVA), DRIL length, foveal retinal thickness (CMT) and ellipsoid zone (EZ) fracture length before and after injection were compared and analyzed, and the correlation between DRIL at 1, 3 and 6 months with BCVA and CMT and ZE fracture length was analyzed. Results: DRIL length, CMT and EZ break length were different between the two groups before treatment (P < 0.05), and 1, 3, 6 month BCVA, DRIL length, CMT and EZ break length were improved after treatment (P < 0.05), and the improvement of DRIL ≤ 500 μm group was better than that of DRIL > 500 μm group (P < 0.05). The Spearman rank correlation test showed that DRIL was correlated with logMAR BCVA at 1, 3 and 6 months of follow-up (r = 0.556, 0.576, 0.461, P < 0.05), and the correlation was stronger and positively correlated than CMT and EZ break length. Conclusion: Intravitreal injection of anti-VEGF drug Conbercept can improve DRIL in DR patients. DRIL is more correlated with visual function than CMT and EZ, and may be a predictor of BCVA improvement.