| Purpose:To observe the short-term effect of intravitreal injection of conbercept?IVC?on diabetic macular edema?DME?and analyze the influencing factors.Methods:A retrospective cohort study was conducted in 20 eyes of 20 untreated diabetic macular edema?DME?patients who received IVC treatment and were followed up for at least 3 months.At baseline,the patients'sex,age,eye type,smoking,drinking,height and weight?body mass index,BMI?were collected;the course of diabetes mellitus?DM?,diabetic macular edema?DME?,glycohemoglobin A1c?Hb A1c?,fasting plasma glucose?fasting plasma?were recorded Glucose,FPG,insulin use and other blood glucose related indicators;hypertension history,systolic pressure,diastolic pressure,pulse pressure and other blood pressure related indicators;record high-density lipoproteins?HDL?,low-density lipoproteins?IDL?,total cholesterol in serum,TC,TG and apolipoprotein A,Hb,SCR,BUA,neu and so on[1].According to the results of FFA,diabetic retinopathy?DR?grading was recorded.During the treatment,PRP was performed as needed;BCVA and SD-OCT were performed at baseline,1 month and 3 months.The central foveal thickness?CFT?was recorded in the spectral frequency domain optical coherence tomography,and the following lesions were observed in the 1 mm wide area of retina around the fovea:hyperreflective foci?HF?,external limiting membrane?ELM?or ellipsoid Zone?EZ?.In the follow-up of 1 and 3 months,single factor analysis and multiple regression analysis were used to determine the systemic and OCT related factors that affect the short-term efficacy of intravitreal injection of conberceptResults:After IVC treatment,BCVA increased from?0.68±0.23?to?0.50±0.21?,visual effect improved significantly?P=0.008?,CFT decreased from?487.0±229.39?um to?311.80±127.29?um,and edema subsided significantly?P<0.001?.The results of univariate analysis showed that:the worse BCVA at baseline was related to the more BCVA increased in January?P=0.016?;the worse BCVA at baseline?P=0.001?,the higher TC?P=0.019?,and the more HF in outer omentum?P=0.005?were related to the higher BCVA increased in March;the thicker CFT at baseline was related to the thicker CFT at March?P=0.003?;the worse BCVA at baseline?P=0.002?,the higher TC?P=0.04?,and the higher SCR The higher?P=0.026?,the more HF in the outer omentum?P=0.004?,and the more HF in the outer omentum?P=0.001?,the worse BCVA at baseline?P=0.003?,the more HF in the outer omentum?P=0.004?,the more CFT in March.Multivariate regression analysis showed that the worse the baseline BCVA?P=0.015?,the higher the CFT?P=0.033?were the independent risk factors for the worse the BCVA at 3months;the worse the baseline BCVA?P<0.001?,the higher the CFT?P=0.045?were the independent risk factors for the worse the BCVA in January;the thicker the baseline CFT was the independent risk factors for the worse the BCVA at baseline?P=0.004?;the higher the neu?P=0.018?,the elm/EZ discontinuity at baseline?P=0.007?was the independent risk factor of the thicker CFT at 3 months;the higher Tg concentration at baseline was the independent risk factor of the more obvious CFT regression at 1 month?P=0.034?;the higher Tg concentration at baseline?P=0.005?,the higher CFT?P=0.002?was the independent risk factor of the more obvious CFT regression at 3 months.Other factors?age,gender,eye type,smoking or not,history of hypertension,Hb A1c,FPG,HDL,Apo A,Hb,BUA,BMI,whether to use insulin?and eye condition?DR grade,Pr P History?had no significant effect on the efficacy of IVC in the treatment of DME?P>0.05?.The worse BCVA is,the thicker CFT is;the more BCVA is,the more CFT will disappear;the improvement of BCVA and CFT at 1 month can predict the improvement of vision and edema at 3 months.Conclusion:Conbercept is safe and effective in the treatment of DME;the longer the course of DME,the more HF,the higher TC,the higher LDL and SCR are related to the efficacy of IVC in the treatment of DME;at baseline,the thickness of CFT,the poor BCVA,the destruction of elm/EZ,the more HF,the high neu and the high Tg are the risk factors for the poor efficacy of IVC.The more the central fovea edema is eliminated,the better the vision is improved;the visual effect and edema can be roughly predicted by the visual effect and edema at 1 month.In order to improve the visual prognosis and eliminate edema,we should find early treatment for DME patients and control the levels of TC,TG,LDL,SCR and neu when receiving anti VEGF treatment. |
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