Conbercept In Treating Diabetic Macular Edema Based On Optical Coherence Tomography Patterns

Aim:This study aimed to explore the clinical efficacy of intravitreal injection of conbercept(IVC)in diabetic macular edema(DME)based on the morphological pattern on optical coherence tomography(OCT).Methods:In total,74cases(74 eyes)with DME were enrolled.They were classified into three groups based on their OCT patterns:diffuse retinal thickening(DRT),cystoid macular edema(CME),and serous retinal detachment(SRD).All cases were treated with IVC(0.05mg/0.01 mL)in 2+PRN mode.The central retinal thickness was measured using OCT.Heidelberg Spectralis OCT was used to obtain images of macular area through the fovea in Follow up Mode,and the number of hyperreflective foci in the inner and outer retinal layer in the scanning range was counted.The number of hyperreflective foci before and after injection was observed.Results:The 74 eyes consisted of 20 DRT,36 CME,and 18 SRD cases.After IVC,the central retinal thickness in all the groups reduced,the best-corrected visual acuity increased,and the number of hyperreflective foci in the inner and outer retinal layer in the scanning range reduced.Some of them showed that the integrity of the IS/OS layer was repaired.1.There was no significant difference in baseline BCVA between three groups(P>0.05).The 3 records of groups in 3,6,9 months were significantly different from the preoperative baseline,and there was no significant difference between DRT and CME after operation(P<0.05).In group DRT and CME,there were no significant difference in three records after injections at 3,6,9 months respectively(P>0.05).In group SRD,there was significant difference between 3 and 6 months after operation compared with preoperative baseline(P<0.05).There was no significant difference between 12 months after operation compared with baseline(P>0.05).There was no significant difference between the 3records after injections(P>0.05).The effect of injections in group SRD was worse than other two groups,and the difference was statistically significant(P<0.05).2.There was significant difference in baseline CRT between three groups before injections(P<0.05).There was no significant difference between CME and SRD(P>0.05).There were statistically significant differences between three groups in the 3 records at 3,6,9months compared with pre-injection respectively.There was no statistically significant difference between the 3 groups after injections respectively.Compared with the average CRT baseline of the three groups,there were significant differences between DRT and CME,SRD(P<0.05),and there was no significant difference between CME and SRD(P>0.05).After the reexamination in 12 months,there was no significant difference between DRT and CME(P>0.05).There was significant difference between SRD and DRT,CME(P<0.05).3.Pre-injections 3 groups of inner and outer retinal layers were statistically significant difference in hyperreflective foci(F=9.715,8.382,P<0.05,P<0.05),three groups of inner retina layer after injection of hyperreflective foci also had significant difference(F=7.173,P<0.05),but after the injection of the outer retina high reflection foci had no significant difference(F=2.914,P>0.05),three groups after injection of hyperreflective foci were reduced and had significant difference(F=9.715,8.382,P<0.05,P<0.05).4.Pre-injection,there was significant difference in the integrity of IS/OS between three groups(?~2=7.004,P<0.05).12 months after injections,the integrity of three groups were improved,the difference was not statistically significant(?~2=1.822,P>0.05).5.The average injections was(3.54+1.11)times in 74 eyes.Among them,in group DRT was(3.20+0.40)times,in group CME was(3.39+0.95)times,and in group SRD was(4.22+1.55)times.6.No serious complications occurred during the two groups of follow-up visits.Conclusions:IVC is effective in all three morphological patterns on OCT.In morphologically,the central retinal thickness reduced,the number of hyperreflective foci in the inner and outer layers of the retina reduced,and the integrity of IS/OS also repaired,and the best corrected visual acuity could be improved.In this study,the DRT group showed the best effect.