Changes Of Choroidal Thickness In Patients With Severe Non-Proliferative Diabetic Retinopathy With Macular Edema Treated With Conbercept

Objective:To observe the changes of foveal choroidal thickness(FCT)of severe non-proliferative diabetic retinopathy(NPDR)with macular edema(ME)treated with Conbercept ophthalmic injection,evaluate the efficacy of anti-vascular endothelial growth factor(anti-VEGF)drugs and provide a reference for the choice of clinical treatment decision-making.Methods: From October 2017 to December 2018,20 cases(20 eyes)of severe NPDR-ME were selected and included in this study.None of the patients in the group had previously received any related treatment.Informed consent was signed before treatment.The patients in the group received intravitreal injection of Conbercept 0.05 ml,once a month and received three consecutive treatments.Foveal choroidal thickness(FCT)was recorded before and after treatment.At the same time,the best corrected visual acuity(BCVA)and total volume of 6mm-macular area(TMV)were recorded.Each item was measured for three times to obtain the mean value by the same experienced ophthalmologist.During the examination,all subjects were dilated with compound topicamide eye drops.macular area was scanned by enhanced depth imaging(EDI)mode of spectral-domain optical coherence tomography(SD-OCT),and the foveal choroidal thickness of macular spot was measured manually.FCT is defined as the average distance from the outer edge of the hyperreflective zone of the retinal pigment epithelium(RPE)under the macular center to the back rays of the scleral inner layer.6 mm the total volume of the macular area was measured using the OCT encrypted scan mode,the statistical recording was performed.Results: The mean values of BCVA(log MAR)were 0.49 ±0.15 before treatment,and the mean values of BCVA(log MAR)were 0.46 ± 0.14,0.43 ± 0.13,0.38 ± 0.13 at 1 month,2 month and 3 month after treatment,respectively.The BCVA(log MAR)at 1 month,2 month and 3 month after treatment significantly improved compared with the pre-treatment,there was significant difference(P=0.02,P=0.00,P=0.00).The mean value of TMV was 17.78 ± 2.15 ㎜ 3 before treatment,and the mean value of TMV decreased to 15.38 ± 2.31 ㎜ 3,13.22 ± 2.23 ㎜ 3 and 10.98 ± 1.86 ㎜ 3 at 1 month,2 month and 3 month after treatment,respectively.The TMV of patients after treatment was significantly lower than baseline TMV(all P<0.05).The mean value of FCT was 232.90 ± 20.85μm before treatment,and it reduced to 218.90 ± 18.17μm,212.75 ± 17.66μm,193.55 ± 11.17μm at 1 month,2 month and 3 month after treatment,respectively.Compared with baseline FCT,FCT at 1 month,2 month and 3 month after treatment was significantly lower,and there was significant difference(all P<0.05).Conclusion: 1.The macular foveal choroidal thickness(FCT)was lower compared with that before treatment,and the best corrected visual acuity(BCVA)was significantly improved compared with that before treatment.The total macular volume(TMV)of 6mm was significantly reduced compared with that before treatment.2.Intravitreal injection of Conbercept is effective for the treatment of severe NPDR-ME.The thickness of choroid under the macular fovea can be used as a quantitative index to measure the change of the patientundefineds condition,provide a reference for the clinical treatment decision-making.