Comparison of efficacy between intravitreal injection of conbercept with and without macular photocoagulation for diabetic macular edema / 中华实验眼科杂志

ABSTRACT

Objective:To compare the clinical efficiency and safety between intravitreal injection of conbercept with and without macular photocoagulation for diabetic macular edema (DME).Methods:A non-random controlled study was conducted.Sixty patients (60 eyes) with DME treated in Shenzhen People's Hospital from January 2017 to January 2020 were enrolled.The patients receiving intravitreal injection of conbercept alone were divided into conbercept injection group (33 cases, 33 eyes), and those who underwent macular photocoagulation combined with intravitreal injection of conbercept were divided into combined treatment group (27 cases, 27 eyes). Best corrected visual acuity (BCVA) was examined using Early Treatment of Diabetic Retinopathy Study.The BCVA, central macular thickness (CMT) and fluorescein fundus angiography (FFA) examination were performed to observe the changes of macular edema and leakage area before and at 1, 3, 6, 9 and 12 months after treatment.The injection frequency, ocular and systemic complications were recorded.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Shenzhen Pepole's Hospital (No.LL-YK-20170405). Written informed consent was obtained from each patient prior to any medical examination.Results:There were better mean BCVA and lower CMT at 1, 3, 6, 9 and 12 months after treatment compared with the BCVA and CMT before treatment in the two groups (all at P<0.05). At 12 months after treatment, FFA showed that the improvement rate of macular edema was 91.0% (30/33) in the conbercept injection group and 96.3% (26/27) in the combined treatment group, showing a statistically significant difference between them ( χ2=3.430, P<0.05). The injection frequency was (4.36±1.62) times in the conbercept injection group, which was significantly higher than (3.41±0.64) times in the combined treatment group ( t=9.211, P<0.05). No ocular adverse events, including ocular hypertension, endophthalmitis and retinal pigment epithelial tears or systemic complications were found during the follow-up. Conclusions:Intravitreal injection of conbercept with or without macular photocoagulation can both maintain or improve visual acuity and alleviate exudative macular edema.They both show good safety, and the combined therapy has better long-term efficacy than conbercept alone.