| Objective:To analyze the clinical efficacy of Intravitreal injection of conbercept combined with retinal laser photocoagulation treatment for following 3A Coats disease,to explore the correlation factors which affect BCVA of Coats disease.Methods:A retrospective case-control study,the analysis since June 2014 ~ May 2016 according fluorescence fundus angiography,(FFA)and optic coherence tomography(OCT)diagnosed with following 3A(including 2A,2B,3A)Coats disease patients22 cases(22 eyes),21 cases(21 eyes,men),women in 1 cases(1eyes);Including 10 patients accept Intravitreal injection of conbercept,1 week after the FFA guiding retinal laser photocoagulation,repeated treatment when necessary,received combined group;Directly in 12 patients of retinal laser photocoagulation,repeated laser when necessary,according to the eyeground situation,received simple retinal laser photocoagulation group.To observe best corrected visual acuity(BCVA)of initial,1mo,3mo,6mo,finial,central macular thickness(CMT),subfoveal hard exudates(SHE),frequency of laser and complications;Eyesight improve or fall by more than 2 rows as vision or declining,vision changes within 2 rows for visual stability.Follow-up time is 10 ~ 18 months,an average of 14.6 months.Results:1.BCVA:Combined group: BCVA of initial,1mo,3mo,6mo and finial were(0.92±0.32)?(0.87±0.33)?(0.85±0.36)(0.84±0.33)?(0.82±0.31)LogMAR,which the BCVA of initial compared with the BCVA of 1mo had no statistical significance(P=0.068),but the BCVA of 10 eyes(100%)were Stable or improved,which compared with the BCVA of 3mo,6mo,finial had statistical significance(p=0.003,p=0.009,p=0.002)?Simple group: BCVA of initial,1mo,3mo,6mo and finial were(0.93±0.30)?(0.92±0.35)?(0.94±0.32)?(0.95±0.34)?(0.95±0.37)LogMAR,the BCVA of initial compared with the BCVA of 1mo,3mo,6mo and finial had no statistical significance(p=0.546,p=0.719,p=0.851,p=0.210).BCVA comparison between the two groups:which initial had no statistical significance(p=0.634).which 1mo had no statistical significance(p=0.187),3mo,6mo and finial had statistical significance(p=0.010,p=0.012,P=0.011).2.CMT:Combined group: CMT of initial,1mo,3mo,6mo and finial were(371.13 ±85.03)?(334.20±58.77)?(300.27±43.01)?(267.00±40.23)?(234.67±31.75)? m,CMT of initial compared with CMT of 1mo,3mo,6mo and finial,which had statistical significance(p=0.001,p=0.000,p=0.000,p=0.000).Simple group: CMT of initial,1mo,3mo,6mo and finial were(358.27±67.30)?(351.87±66.39)?(341.20±70.08)?(342.93±89.65)?(360.93±77.47)?m,CMT of initial compared with CMT of 1mo,6mo and finial,which had no statistical significance(p=0.128,P=0.074,P=0.744),but which compared with CMT of 3mo had statistical significance(p=0.010).CMT comparison between the two groups:which initial had no statistical significance(p=0.124).which 1mo,3mo,6mo and finial had statistical significance(p=0.006,P=0.002,P=0.001,P=0.000).3.Tow groups in the initial and finial BCVA with SHE were poorer than without SHE,which had statisticance significant(P=0.002,p=0.002 P=0.022,p=0.006).Which combined group with SHE compared with simple group with SHE in the BCVA of finial had statisticance significant(P=0.008).4.The number of intravitreal injection was2.7 times,and the number of retinal laser photocoagulation 2 times,in the combined group,and 4.5 times in simple group during following-up times,which had statisticance significant(P<0.05).5.Complication comparison:combined group had no complication,but,simple group had 3 eyes PVR,2 eyes retinal scarring,vascular occlusion.Conclusion:1.Intravitreal injection of conbercept combined with retinal laser photocoa-gulation were effective for following 3A Coats disease,which can improve vision,decrease CMT,improve the macular area,reduce the number of retinal laser photocoagulation and complications.2.BCVA of finial were related to BCVA of initial and SHE,shape and structure of the macular area influence prognosis efficacy. |
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