Optic coherence tomography-guided repeated intravitreal injections of conbercept for macular edema of retinal vein occlusion_Chinese Journal of Ocular Fundus Diseases

Authors：

 Huang Zhijian , Song Yanping , Din Qing , Yan Ming

Department of Ophthalmology, Wuhan General Hospital, Wuhan 430070, China;

Corresponding author：

Huang Zhijian, Email: huangzhijian149696@163.com

Keywords：

Retinal vein occlusion/therapy; Macular edema /therapy; Angiogenesis inhibitors/therapeutic use; Antibodies, monoclonal/therapeutic use; Tomography, optical coherence

DOI：

10.3760/cma.j.issn.1005-1015.2017.02.004

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Objective To evaluate the effectiveness of repeated intravitreal conbercept injection in patients with macular edema (ME) of retinal vein occlusion (RVO), guided by optic coherence tomography (OCT). Methods It is a retrospective case study. Forty patients (40 eyes) diagnosed as ME secondary to RVO were enrolled in this study. There were 19 males (19 eyes) and 21 females (21 eyes), with the mean age of (53.58±13.19) years and the mean course of 1.5 months. The best corrected visual acuity (BCVA), indirect ophthalmoscopy, fundus fluorescein angiography (FFA) and OCT were performed. The mean baseline of BCVA, central macular thickness (CMT) were 0.25±0.18 and (509.48±170.13) μm respectively. All the patients were treated with 10.00 mg/ml conbercept 0.05 ml (including conbercept 0.5 mg). Follow-up of these patients was 1 to 6 months after treatments, the BCVA, fundus manifestations, OCT were retrospectively observed by every month, the FFA was retrospectively observed by every 3 months. When there was retinal edema or CMT ≥50 μm by OCT during follow-up, those patients were retreated with intravitreal conbercept injection. The changes of the BCVA, CMT were evaluated before and after treatment. Meanwhile, complications in eyes related to medicine and treatment methods were evaluated too. Results At the 6 months, the BCVA was improved (increase≥2 lines) in 25 eyes (62.50%), stabilized (±1 line) in 13 eyes (32.50%) and decreased 2 lines in 2 eyes (5.00%). Retinal hemorrhage and exudates were absorbed in most patients. FFA showed no fluorescein leakage in 11 eyes (27.50%), minor fluorescein leakage in 26 eyes (65.00%), and retinal capillary non-perfusion in 3 eyes (7.50%). OCT showed absorption of the subretinal fluid. The mean CMT were (235.20±100.44) μm at 6 months. Intravitreal injection of conbercept was applied for 4 times in 8 eyes (20.00%), 3 times for 18 eyes (45.00%), and 2 times for 14 eyes (35.00%). The mean number of intravitreal injection was 2.85 times. There were no ocular or systemic adverse events observed in all patients. Conclusion Intravitreal conbercept injection is an efficacy and safe treatment for the patients with ME of RVO guided by OCT. It can stabilize and improve the visual acuity.

Citation： Huang Zhijian, Song Yanping, Din Qing, Yan Ming. Optic coherence tomography-guided repeated intravitreal injections of conbercept for macular edema of retinal vein occlusion. Chinese Journal of Ocular Fundus Diseases, 2017, 33(2): 124-128. doi: 10.3760/cma.j.issn.1005-1015.2017.02.004 Copy

1.	毕燃, 贾彩华, 于越, 等. 康柏西普治疗视网膜静脉阻塞黄斑水肿的临床观察[J]. 赤峰学院学报(自然科学版), 2014(23): 71-73. DOI: 1673-260X(2014)12-0071-03.Bi R, Jia CH, Yu Y, et al. Clinical study on conbercept ophthalmic injection for macular edema induced by retinal vein occlusion[J]. Journal of Chifeng University (Natural Science Edition), 2014(23): 71-73. DOI: 1673-260X(2014)12-0071-03.
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5.	苏钰, 陈长征, 李璐, 等. 玻璃体腔注射Bevacizumab与曲氨奈德治疗视网膜静脉阻塞继发黄斑水肿比较研究[J]. 武汉大学学报(医学版), 2011, 32(3): 338-342. DOI: 10.14188/j.1671-8852. 2011.03.033.Su Y, Chen CZ, Li L, et al. Comparative research of intravitreal bevacizumab versus triamcinolone treatment for macular edema in retinal vein occlusion[J]. Medical Journal of Wuhan University, 2011, 32(3): 338-342. DOI: 10.14188/j.1671-8852.2011.03.033.
6.	张海宁, 杨继红, 吴子旭. 光学相干断层扫描在激光治疗视网膜静脉阻塞疗效观察中的应用[J]. 眼科新进展, 2007, 27(6): 440-442. DOI: 10.3969/j.issn.1003-5141.2007.06.011.Zhang HN, Yang JH, Wu ZX.Application of optical coherence tomography in observing the therapeutic effect of retinal vein occlusion by laser coagulation[J]. Rec Adv Ophthalmol, 2007, 27(6): 440-442. DOI: 10.3969/j.issn.1003-5141.2007.06.011.
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10.	Noma H, Funatsu H, Mimura T, et al. Vascular endothelial growth factor receptor-2 in macular oedema with retinal vein occlusion[J]. Ophthalmic Res, 2012; 48(1): 56-58. DOI: 10.1159/000336020.
11.	金昱, 石安娜, 刘淼. 玻璃体内注射雷珠单抗(Ranibizumab)治疗视网膜静脉阻塞继发黄斑水肿[J]. 眼科新进展, 2014, 34(9): 855-857. DOI: 10.13389/j.cnki.rao.2014.0236.Jin Y, Shi AN, Liu M.Intravitreal injection of ranibizumab for macular edema secondary to retinal vein occlusion[J]. Rec Adv Ophthalmol, 2014, 34(9): 855-857. DOI: 10.13389/j.cnki. rao.2014.0236.
12.	朱海燕, 金学民, 金波, 等. 玻璃体腔注射阿瓦斯汀治疗视网膜静脉阻塞性黄斑水肿[J]. 中华眼外伤职业眼病杂志, 2010, 32(6): 405-408. DOI: 10.3760/cma.j.issn.2095-1477.2010.06.002.Zhu HY, Jin XM, Jin B, et al. Intravitreal Avastin treatment for macular edema due to retinal vein occlusion[J]. Chin J Ocul Traum Occupat Eye Dis, 2010, 32(6): 405-408. DOI: 10.3760/cma. j.issn.2095-1477.2010.06.002.
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1. 毕燃, 贾彩华, 于越, 等. 康柏西普治疗视网膜静脉阻塞黄斑水肿的临床观察[J]. 赤峰学院学报(自然科学版), 2014(23): 71-73. DOI: 1673-260X(2014)12-0071-03.Bi R, Jia CH, Yu Y, et al. Clinical study on conbercept ophthalmic injection for macular edema induced by retinal vein occlusion[J]. Journal of Chifeng University (Natural Science Edition), 2014(23): 71-73. DOI: 1673-260X(2014)12-0071-03.
2. 张菁, 蔡小军, 陈晓敏, 等. 玻璃体腔注射康柏西普联合视网膜激光光凝治疗视网膜分支静脉阻塞继发黄斑水肿疗效观察[J]. 中华眼底病杂志, 2015, 31(1): 22-26. DOI: 10.3760/cma.j.issn.1005-1015.2015.01.007.Zhang J, Cai XJ, Chen XM, et al. A prospective randomized clinical trial on intravitreous injection of Conbercept combined with laser photocoagulation for macular edema secondary to branch retinal vein occlusion[J]. Chin J Ocul Fundus Dis, 2015, 31(1): 22-26. DOI: 10.3760/cma.j.issn.1005-1015.2015.01.007.
3. 段直光, 贾云琴, 莫逆, 等. Bevacizumab治疗视网膜静脉阻塞继发黄斑水肿的临床观察[J]. 国际眼科杂志, 2014, 14(9): 1594-1598. DOI: 10.3980/j.issn.1672-5123.2014.09.09.Duan ZG, Jia YQ, Mo N, et al. Clinical study on Bevacizumab for macular edema induced by retinal vein occlusion[J]. Int Eye Sci, 2014, 14(9): 1594-1598. DOI: 10.3980/j.issn.1672-5123.2014.09.09.
4. Rouvas A, Petrou P, Ntouraki A, et al. Intravitreal ranibizumab (Lucentis) for branch retinal vein occlusion-induced macular edema: nine-month results of a prospective study[J]. Retina, 2010, 30(6): 893-902.DOI: 10.1097/IAE.0b013e3181cd4894.
5. 苏钰, 陈长征, 李璐, 等. 玻璃体腔注射Bevacizumab与曲氨奈德治疗视网膜静脉阻塞继发黄斑水肿比较研究[J]. 武汉大学学报(医学版), 2011, 32(3): 338-342. DOI: 10.14188/j.1671-8852. 2011.03.033.Su Y, Chen CZ, Li L, et al. Comparative research of intravitreal bevacizumab versus triamcinolone treatment for macular edema in retinal vein occlusion[J]. Medical Journal of Wuhan University, 2011, 32(3): 338-342. DOI: 10.14188/j.1671-8852.2011.03.033.
6. 张海宁, 杨继红, 吴子旭. 光学相干断层扫描在激光治疗视网膜静脉阻塞疗效观察中的应用[J]. 眼科新进展, 2007, 27(6): 440-442. DOI: 10.3969/j.issn.1003-5141.2007.06.011.Zhang HN, Yang JH, Wu ZX.Application of optical coherence tomography in observing the therapeutic effect of retinal vein occlusion by laser coagulation[J]. Rec Adv Ophthalmol, 2007, 27(6): 440-442. DOI: 10.3969/j.issn.1003-5141.2007.06.011.
7. Chan A, Duker J S. A standardized method for reporting changes in macular thickening using optical coherence tomography[J]. Arch Ophthalmol, 2005, 123(7): 939-943.
8. Ng EWM, Adamis AP. Targeting angiogenesis, the underlying disorder in neovascular age-related macular degeneration [J]. Can J Ophthalmol, 2005, 40(3): 352-368.
9. Noma H, Funatsu H, Mimura T, et al. Role of soluble vascular endothelial growth factor receptor-2 in macular oedema with central retinal vein occlusion[J]. Br J Ophthalmol, 2011, 95(6): 788-792. DOI: 10.1136/bjo.2010.192468.
10. Noma H, Funatsu H, Mimura T, et al. Vascular endothelial growth factor receptor-2 in macular oedema with retinal vein occlusion[J]. Ophthalmic Res, 2012; 48(1): 56-58. DOI: 10.1159/000336020.
11. 金昱, 石安娜, 刘淼. 玻璃体内注射雷珠单抗(Ranibizumab)治疗视网膜静脉阻塞继发黄斑水肿[J]. 眼科新进展, 2014, 34(9): 855-857. DOI: 10.13389/j.cnki.rao.2014.0236.Jin Y, Shi AN, Liu M.Intravitreal injection of ranibizumab for macular edema secondary to retinal vein occlusion[J]. Rec Adv Ophthalmol, 2014, 34(9): 855-857. DOI: 10.13389/j.cnki. rao.2014.0236.
12. 朱海燕, 金学民, 金波, 等. 玻璃体腔注射阿瓦斯汀治疗视网膜静脉阻塞性黄斑水肿[J]. 中华眼外伤职业眼病杂志, 2010, 32(6): 405-408. DOI: 10.3760/cma.j.issn.2095-1477.2010.06.002.Zhu HY, Jin XM, Jin B, et al. Intravitreal Avastin treatment for macular edema due to retinal vein occlusion[J]. Chin J Ocul Traum Occupat Eye Dis, 2010, 32(6): 405-408. DOI: 10.3760/cma. j.issn.2095-1477.2010.06.002.
13. Campochiaro PA, Hafiz G, Mir TA, et al. Scatter photocoagulation does not reduce macular edema or treatment burden in patients with retinal vein occlusion: the relate trial[J]. Ophthalmology, 2015, 122(7): 1426-1437. DOI: 10.1016/j.ophtha.2015.04.006.
14. Hoeh AE, Ach T, Schaal KB, et al. Long-term follow-up of OCT-guided bevacizumab treatment of macular edema due to retinal vein occlusion[J]. Graefe’s Arch Clin Exp Ophthalmol, 2009, 247(12): 1635-1641. DOI: 10.1007/s00417-009-1151-1.

Chinese Journal of Ocular Fundus Diseases

Optic coherence tomography-guided repeated intravitreal injections of conbercept for macular edema of retinal vein occlusion

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