| Objective:To observe the changes of retinal thickness and retinal blood flow in macular area after intravitreal conbercept or grid photocoagulation in patients diabetic macular edema(DME)by optical coherence tomography angiography(OCTA).Methods:Prospective control study.A total of 40 patients(45 eyes)with DME diagnosed in the ophthalmology department of the first affiliated hospital of bengbu medical college from December 2018 to October 2019 were selected,and these patients were randomly divided into the injection group and laser group.20 patients(23 eyes)in the injection group were given intravitreal injection of Conbercept 0.05ml per month for3 consecutive injections.In the laser group,20 patients with 22 eyes received the best corrected visual acuity(BCVA)and OCTA check standard macular area grid photocoagulation.All patients received BCVA and OCTA check before and 1、2、3months after treatment.BCVA,central macular thickness(CMT),foveal avascular zone(FAZ),vessel density of superficial capillary plexus(SVD)and vessel density of deep capillary plexus(DVD)before and after treatment of two groups were analyzed.Results:1.In the injection group,BCVA(logMAR)at 1,2 and 3 months after treatment were 0.47±0.22,0.36±0.18 and 0.36±0.23,respectively,significantly improved from baseline(0.63±0.23)(all P<0.05).In the laser group,BCVA(logMAR)at 1 and 2 months after treatment were 0.53±0.21 and 0.53±0.22,respectively,with slight improvement from baseline(0.58±0.18)(P<0.05),and then decreased to baseline again at 3 months after treatment(0.59±0.25)(P﹥0.05).2.After treatment,In the injection group CMT at 1,2 and 3 months after treatment were 332.43±39.40μm,330.40±42.66μm,323.07±47.14μm,respectively,significantly decreased from baseline(442.03±52.60μm)(all P<0.05).In the laser group,CMT at 1,2 and 3 months after treatment were 371.33±67.90μm,376.40±71.87μm,394.87±70.44μm,respectively,significantly decreased from baseline(432.93±71.81μm)(all P<0.05).3.In the injection group,FAZ at 1,2 and 3 months after treatment were 0.39±0.03 mm~2,0.39±0.05 mm~2and 0.40±0.06 mm~2,respectively,had no significant difference with baseline(0.39±0.04 mm~2)(all P﹥0.05).In the laser group,FAZ at 1,2 and 3 months after treatment were 0.39±0.04 mm~2,0.40±0.04 mm~2,0.39±0.06 mm~2,respectively,had no significant difference with baseline(0.40±0.04 mm~2)(all P﹥0.05).4.In the injection group,SVD at 1,2 and 3 months after treatment were(37.09±2.84)%,(37.04±3.13 3)%,(37.26±3.35)%,respectively,had no significant difference with baseline(37.20±3.05)%(all P﹥0.05).In the laser group,SVD at 1,2 and 3 months after treatment were(35.17±3.68)%,(35.40±3.28)%,(35.48±3.05)%,respectively,had no significant difference with baseline(35.41±3.98)%(all P﹥0.05).5.In the injection group,DVD at 1,2 and 3 months after treatment were(38.92±2.72)%,(39.16±2.78),(39.35±3.08)%,respectively,had no significant difference with baseline(39.18±3.04)%(all P﹥0.05).In the laser group,DVD at 1,2 and 3 months after treatment were(37.68±3.03),(37.82±3.41),(37.91±3.26)%,respectively,had no significant difference with baseline(37.55±3.32)%(all P﹥0.05).6.Comparing the two groups,there was no statistically significant difference among the indicators at baseline.After treatment,the injection group had better visual acuity and decreased CMT than the laser group(all P<0.05).And there was no significant difference in FAZ area,SVD and DVD between the two groups after treatment(all P﹥0.05).Conclusion:1.Intravitreal injection of Conbercept could significantly improve the vision and reduce the CMT in DME patients,but had no significant effect on the FAZ area,SVD and DVD.2.Grid photocoagulation in macular area can improve the vision of DME patients in a short term in the first 2 months,but after 3 months,there is no obvious improvement in vision.And grid photocoagulation can reduce the CMT,but has no obvious effect on the FAZ area,SVD and DVD.3.Compared with grid photocoagulation,intravitreal injection of Conbercept can better maintain improved vision and reduce CMT. |
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