Clinical Research On The Effect Of Conbercept On Wet Age-Related Macular Degeneration By Optical Coherence Tomography Angiography

Objective:Optical coherence tomography angiography(OCTA)was used to observe the change of central macular thickness(CMT),deep foveal vessel density(DFVD),superficial foveal vessel density(SFVD)and choroidal vessel density(CVD)before and after intravitreal injection of Conbercept in patients diagnozed as wet age-related macular degeneration(w AMD).Method:A total of 66 eyes from 66 subjects were diagnosed as w AMD in the First Affiliated Hospital of Fujian Medical University from October,2017 to February,2019.According to the 3+PRN treatment regimen,intravitreal injection of Conpbercept was given.The best corrected visual acuity(BCVA)recorded by Early Treatment Diabetic Retinopathy Study(ETDRS)letter score was collected before the injection and 1 month,3 months,6 months and 12 months afterwards.The OCTA 6mm×6mm range mode was used to check central macular thickness(CMT),choroidal thickness(CT),foveal avascular area(FAZ),deep foveal vessel density(DFVD),superficial foveal vessel density(SFVD)and choroidal vessel density(CVD).All the above data were obtained from the OCTA’s own software.Each index before the injection were comapred with that from1 month,3 months,6 months and 12 months after treatment.The correlation between each index was anaylized using the SPSS 23.0 statistical software.Result:After patients treated with intravitreal injection of Conbercept in the 3+PRN treatment regimen,the BCVA was all increased from 1 month,3 months,6 months,and12 months after treatment,and the difference was statistically significant.The baseline BCVA before the treatment was 34.476±24.912,while the BCVA in 1 month after treatment was 41.515±23.030(P<0.001 compared to that before treament).The BCVA in 3 months after treatment was 41.953±22.886(P<0.001 compared to that before treament).The BCVA in 6 months after the treatment was 35.75±24.901(P=0.025compared to that before treament).The BCVA in 12 months after the treatment is 36.538±25.471(P=0.010 compared to that before treament).The CMT was all reduced from 1 month,3 months,6 months after treatment,and the difference was statistically significant.The baseline CMT before the treatment was323.381±120.659μm,while the CMT in 1 month after treatment was 271.833±89.752μm(P=0.001 compared to that before treament).The CMT in 3 months after treatment was 284.654±129.653μm(P=0.002 compared to that before treament).The CMT in 6 months after treatment was 287.281±111.039μm(P=0.003 compared to that before treament).There was no significant difference in CMT between 12 months after treatment and before.The CMT in 12 months after treatment was 288.16±92.190μm(P=0.056 compared to that before treament).The CVD was all increased from 1 month,3 months,6 months after treatment,and the difference was statistically significant,The baseline CVD before treatment was1.550±0.417mm~2,while the CVD in 1 month after treatment was 1.613±0.364mm~2(P=0.012 compared to that before treament).The CVD in 3 months after treatment was1.617±0.342mm~2(P=0.005 compared to that before treament).The CVD in 6 months after treatment was 1.729±0.282mm~2(P<0.001 compared to that before treament).There was no significant difference in CVD between 12 months after treatment and before.The CVD in 12 months after treatment was 1.726±0.242mm~2(P=0.356 compared to that before treament).There was no significant difference in FAZ between 1 month,3 months,6 months and 12 months after treatment and before(P>0.05).There was no significant difference in CT between 1 month,3 months,6 months and 12 months after treatment and before(P>0.05).There was no significant difference in DFVD between 1 month,3months,6 months and 12 months after treatment and before(P>0.05).There was no significant difference in SFVD between 1 month,3 months,6 months and 12 months after treatment and before(P>0.05).There is a negative correlation between BCVA and FAZ(r=-0.261,P=0.023).There is a positive correlation between BCVA and DFVD(r=0.291,P=0.01).There is a positive correlation between BCVA and CVD(r=0.275,P=0.015).There is a negative correlation between CMT and CVD(r=-0.348,P=0.001).Conclusion:The direct observation of the structure of retinal layers and vascular morphology by OCTA can provide relevant quantitative standards for w AMD lesions.It can help us to accurately evaluate the degree and progression of w AMD,and the efficacy of treatment,and provide clinical guidance.Intravitreal injection of Conbercept has a significant effect on w AMD.BCVA is higher than that before the treatment.CMT is reduced compared to that before the treatment.CVD is increased compared to that before the treatment.CMT and CVD are the related factors of BCVA.