The application of conbercept in the treatment of diabetic retinopathy with stage Ⅰ and Ⅱ neovascular glaucoma_Chinese Journal of Ocular Fundus Diseases

Authors：

 Gou Jianyuan

Department of Ophthalmology, Peoples's Hospital of Xianghe, Langfang 065400, China;

Corresponding author：

Gou Jianyuan, Email: ruolan4384@sina.com

Keywords：

Diabetic retinopathy/therapy; Glaucoma, neovascular/therapy; Angiogenesis inhibitors/therapeutic use; Laser coagulation

DOI：

10.3760/cma.j.cn511434-20200812-00390

Video：

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To observe the efficacy of intravitreal injection of conbercept (IVC) combined with panretinal laser photocoagulation (PRP) in the treatment of diabetic retinopathy (DR) combined with stage I and II neovascular glaucoma (NVG).Methods A clinical case-control study. From October 2013 to March 2019, 50 eyes (50 patients) with DR and stage Ⅰ to Ⅱ NVG diagnosed in the Department of Ophthalmology, Peoples's Hospital of Xianghe were were included in the study. There were 27 eyes (27 males) and 23 eyes (23 females); all patients were monocular with the average age of 53.5±7.13 years old. Stage Ⅰ and Ⅱ NVG were 11 and 39 eyes, respectively. All patients underwent BCVA, intraocular pressure, and fundus angiography. The BCVA examination adopted the international standard visual acuity chart, which was converted to logMAR BCVA visual acuity in statistics. The patients were divided into the Conbercept+laser therapy (combination therapy) group and the laser therapy group by random number table, with 25 eyes. The age of the two groups of patients (t=0.058), gender composition ratio (χ²=0.081), logMAR BCVA (t=0.294), intraocular pressure (t=－0.070), the number of eyes with different grades of angle and iris neovascularization（χ²=1.683, 0.854）were compared, the difference was not statistically significant (P＞0.05). The changes of BCVA, intraocular pressure, iris neovascularization, and angular neovascularization were compared and observed between the two groups one week after the completion of PRP treatment, 1, 3, 6, and 9 months. Independent sample t test was used for continuous variables. Between the combination treatment group and the laser treatment group, at different time points within the two groups and the interaction of the two factors, a single-factor repeated analysis of variance was used.Results Compared with the results before treatment, the combined treatment group and laser treatment group had statistically significant differences in the number of angle and iris neovascularization, intraocular pressure and logMAR BCVA at different times after treatment in the combined treatment group and laser treatment group (F=124.211, 65.153, 69.249, 26.848; P＜0.001). After treatment, the combined treatment group was better than the laser treatment group in terms of the regression of eye angle and iris neovascularization, intraocular pressure and logMAR BCVA, and the difference was statistically significant (F=47.543, 25.051, 12.265, 9.994; P=0.001, 0.001, 0.001, 0.003). At different times after treatment, compared with the laser treatment group, the number of neovascularization in the iris and angle of the eye in the combined treatment group was less, the intraocular pressure was significantly decreased, and the BCVA was increased. The difference was statistically significant (P＜0.05).Conclusion The efficacy of Kang IVC combined with PRP in the treatment of DR with stage Ⅰ and Ⅱ NVG is better than that of PRP alone.

Citation： Gou Jianyuan. The application of conbercept in the treatment of diabetic retinopathy with stage Ⅰ and Ⅱ neovascular glaucoma. Chinese Journal of Ocular Fundus Diseases, 2020, 36(10): 759-763. doi: 10.3760/cma.j.cn511434-20200812-00390 Copy

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4.	海鸥, 刘芳, 高丹宇. 玻璃体腔注射康柏西普联合Ahmed青光眼引流阀植入和视网膜光凝治疗新生血管性青光眼[J]. 中华眼视光学与视觉科学杂志, 2019, 21(11): 838-841. DOI: 10.3760/cma.j.issn.1674-845X.2019.11.007.Hai O, Liu F, Gao DY. Intravitreal injection of conbercept combined with ahemd glaucoma valve implants and panretinal photocoagulation treatment for neovascular glaucoma[J]. Chin J Ophthalmol Vis Sci, 2019, 21(11): 838-841. DOI: 10.3760/cma.j.issn.1674-845X.2019.11.007.
5.	李鹏, 陈海艳, 海鸥, 等. 康柏西普玻璃体腔注射联合EX-PRESS青光眼引流器植入治疗NVG[J]. 国际眼科杂志, 2019, 19(7): 1218-1221. DOI: 10.3980/j.issn.1672-5123.2019.7.32.Li P, Chen HY, Hai O, et al. Conbercept intravitreal injection combined with EX-PRESS glaucoma drainage device implantation for NVG[J]. Int Eye Sci, 2019, 19(7): 1218-1221. DOI: 10.3980/j.issn.1672-5123.2019.7.32.
6.	Elmekawey H, Khafagy A. Intracameral ranibizumab and subsequent mitomycm C augmented trabeculectomy in neovascular glaucoma[J]. J Glaucoma, 2014, 23(7): 419-484. DOI: 10.1097/IJG.0b013e3182946398.
7.	吴敏, 薛黎萍, 和丹, 等. 23G玻璃体切割术联合全视网膜光凝和二期Ahmed引流阀植入治疗新生血管性青光眼疗效探讨[J]. 中国实用眼科杂志, 2015, 33(11): 1284-1287. DOI: 10.3760/cma.j.issn.1006-4443.2015.11.026.Wu M, Xue LP, He D, et al. The outcome of 23 Gauge vitrectomy combined with pan retina photocoagulation followed by Ahmed glaucoma valve implantation in neovascular glaucoma[J]. Chin J Pract Ophthalmol, 2015, 33(11): 1284-1287. DOI: 10.3760/cma.j.issn.1006-4443.2015.11.026.
8.	刘颖, 葛翠洁, 谢丽丽, 等. 康柏西普联合手术及全视网膜光凝治疗NVG的临床研究[J]. 中国现代医学杂志, 2018, 28(15): 67-70. DOI: 10.3969/j.issn.1005-8982.2018.15.014.Liu Y, Ge CJ, Xie LL, et al. Application of Compaq combined with trabeculectomy and whole retinal photocoagulation in neovascular glaucoma[J]. China Journal of Modern Medicine, 2018, 28(15): 67-70. DOI: 10.3969/j.issn.1005-8982.2018.15.014.
9.	刘霞, 顾莉莉. 新生血管性青光眼应用全视网膜光凝、玻璃体内注射康柏西普联合手术治疗的效果[J]. 临床医学研究与实践, 2018, 3(29): 72-73. DOI: 10.19347/j.cnki.2096-1413.201829034.Liu X, Gu LL. Effect of panretinal photocoagulation and intravitreal injection of conbercept combined with surgery on neovascular glaucoma[J]. Clinical Research and Practice, 2018, 3(29): 72-73. DOI: 10.19347/j.cnki.2096-1413.201829034.
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11.	张娣, 张玲, 杨静, 等. 玻璃体内注射康柏西普联合手术及全视网膜光凝治疗新生血管性青光眼[J]. 眼科新进展, 2015, 35(12): 1170-1172. DOI: 10.13389/j.cnki.rao.2015.0320.Zhang D, Zhang L, Yang J, et al. Intravitreal injection of conbercept combined with operation and panretinal photocoagulation for neovascular glaucoma[J]. Rec Adv Ophthalmol, 2015, 35(12): 1170-1172. DOI: 10.13389/j.cnki.rao.2015.0320.
12.	刘修铎, 徐惠娣, 孙钰, 等. 超全视网膜光凝联合玻璃体腔注射康柏西普治疗新生血管性青光眼[J]. 国际眼科杂志, 2017, 17(1): 140-142. DOI: 10.3980/j.issn.1672-5123.2017.1.38.Liu XD, Xu HD, Sun Y, et al. Treatment of intravitreal injection of conbercept with extra-panretinal photocoagulation for neovascular glaucoma[J]. Int Eye Sci, 2017, 17(1): 140-142. DOI: 10.3980/j.issn.1672-5123.2017.1.38.

1. 苏锐锋, 苏畅, 董微丽, 等. 两种方法治疗新生血管性青光眼的临床观察[J]. 国际眼科杂志, 2019, 19(6): 1048-1051. DOI: 10.3980/j.issn.1672-5123.2019.6.35.Su RF, Su C, Dong WL, et al. Clinical observation of two methods in treatment of neovascular glaucoma[J]. Int Eye Sci, 2019, 19(6): 1048-1051. DOI: 10.3980/j.issn.1672-5123.2019.6.35.
2. 张爱平. 玻璃体腔注射康柏西普联合小梁切除术及视网膜光凝治疗新生血管性青光眼[J]. 山西医药杂志, 2018, 47(15): 1753-1755. DOI: 10.3969/j.issn.0253-9926.2018.15.003.Zhang AP. Intravitreal injection of combercept combined with trabeculectomy and retinal photocoagulation for neovascular glau-coma[J]. Shanxi Medical Journal, 2018, 47(15): 1753-1755. DOI: 10.3969/j.issn.0253-9926.2018.15.003.
3. 鱼喆, 蒲晓莉, 延新年, 等. 玻璃体腔注射康柏西普联合小梁切除术及全视网膜光凝治疗新生血管性青光眼[J]. 国际眼科杂志, 2018, 18(5): 862-865. DOI: 10.3980/j.issn.1672-5123.2018.5.23.Yu Z, Pu XL, Yan XN, et al. Intravitreal injection of conbercept combined with trabeculectomy and panretinal photocoagulation for the treatment of neovascular glaucoma[J]. Int Eye Sci, 2018, 18(5): 862-865. DOI: 10.3980/j.issn.1672-5123.2018.5.23.
4. 海鸥, 刘芳, 高丹宇. 玻璃体腔注射康柏西普联合Ahmed青光眼引流阀植入和视网膜光凝治疗新生血管性青光眼[J]. 中华眼视光学与视觉科学杂志, 2019, 21(11): 838-841. DOI: 10.3760/cma.j.issn.1674-845X.2019.11.007.Hai O, Liu F, Gao DY. Intravitreal injection of conbercept combined with ahemd glaucoma valve implants and panretinal photocoagulation treatment for neovascular glaucoma[J]. Chin J Ophthalmol Vis Sci, 2019, 21(11): 838-841. DOI: 10.3760/cma.j.issn.1674-845X.2019.11.007.
5. 李鹏, 陈海艳, 海鸥, 等. 康柏西普玻璃体腔注射联合EX-PRESS青光眼引流器植入治疗NVG[J]. 国际眼科杂志, 2019, 19(7): 1218-1221. DOI: 10.3980/j.issn.1672-5123.2019.7.32.Li P, Chen HY, Hai O, et al. Conbercept intravitreal injection combined with EX-PRESS glaucoma drainage device implantation for NVG[J]. Int Eye Sci, 2019, 19(7): 1218-1221. DOI: 10.3980/j.issn.1672-5123.2019.7.32.
6. Elmekawey H, Khafagy A. Intracameral ranibizumab and subsequent mitomycm C augmented trabeculectomy in neovascular glaucoma[J]. J Glaucoma, 2014, 23(7): 419-484. DOI: 10.1097/IJG.0b013e3182946398.
7. 吴敏, 薛黎萍, 和丹, 等. 23G玻璃体切割术联合全视网膜光凝和二期Ahmed引流阀植入治疗新生血管性青光眼疗效探讨[J]. 中国实用眼科杂志, 2015, 33(11): 1284-1287. DOI: 10.3760/cma.j.issn.1006-4443.2015.11.026.Wu M, Xue LP, He D, et al. The outcome of 23 Gauge vitrectomy combined with pan retina photocoagulation followed by Ahmed glaucoma valve implantation in neovascular glaucoma[J]. Chin J Pract Ophthalmol, 2015, 33(11): 1284-1287. DOI: 10.3760/cma.j.issn.1006-4443.2015.11.026.
8. 刘颖, 葛翠洁, 谢丽丽, 等. 康柏西普联合手术及全视网膜光凝治疗NVG的临床研究[J]. 中国现代医学杂志, 2018, 28(15): 67-70. DOI: 10.3969/j.issn.1005-8982.2018.15.014.Liu Y, Ge CJ, Xie LL, et al. Application of Compaq combined with trabeculectomy and whole retinal photocoagulation in neovascular glaucoma[J]. China Journal of Modern Medicine, 2018, 28(15): 67-70. DOI: 10.3969/j.issn.1005-8982.2018.15.014.
9. 刘霞, 顾莉莉. 新生血管性青光眼应用全视网膜光凝、玻璃体内注射康柏西普联合手术治疗的效果[J]. 临床医学研究与实践, 2018, 3(29): 72-73. DOI: 10.19347/j.cnki.2096-1413.201829034.Liu X, Gu LL. Effect of panretinal photocoagulation and intravitreal injection of conbercept combined with surgery on neovascular glaucoma[J]. Clinical Research and Practice, 2018, 3(29): 72-73. DOI: 10.19347/j.cnki.2096-1413.201829034.
10. Kwon J, Sung KR. Effect of preoperative intravitreal bevacizumab on the surgical outcome of neovascular glaucoma at different stages[J/OL]. J Ophthalmol, 2017, 2017: 7672485[2017-06-20]. https://doi.org/10.1155/2017/7672485. DOI: 10.1155/2017/7672485.
11. 张娣, 张玲, 杨静, 等. 玻璃体内注射康柏西普联合手术及全视网膜光凝治疗新生血管性青光眼[J]. 眼科新进展, 2015, 35(12): 1170-1172. DOI: 10.13389/j.cnki.rao.2015.0320.Zhang D, Zhang L, Yang J, et al. Intravitreal injection of conbercept combined with operation and panretinal photocoagulation for neovascular glaucoma[J]. Rec Adv Ophthalmol, 2015, 35(12): 1170-1172. DOI: 10.13389/j.cnki.rao.2015.0320.
12. 刘修铎, 徐惠娣, 孙钰, 等. 超全视网膜光凝联合玻璃体腔注射康柏西普治疗新生血管性青光眼[J]. 国际眼科杂志, 2017, 17(1): 140-142. DOI: 10.3980/j.issn.1672-5123.2017.1.38.Liu XD, Xu HD, Sun Y, et al. Treatment of intravitreal injection of conbercept with extra-panretinal photocoagulation for neovascular glaucoma[J]. Int Eye Sci, 2017, 17(1): 140-142. DOI: 10.3980/j.issn.1672-5123.2017.1.38.

Chinese Journal of Ocular Fundus Diseases

The application of conbercept in the treatment of diabetic retinopathy with stage Ⅰ and Ⅱ neovascular glaucoma

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