| Pathologic myopia choroidal neovascularization in macular area is one of the main reasons of vision impairment.It,s pathogenesis has three hypothesizes,the three hypothesizes are Mechanical theory,Heredo-degenerative theory,Hemodynamic changes in choroidal circulation.They interact to destroy the blance of vascular endothelial growth factor(VEGF)and anti-angiogenesis agents,so they leads to neovascularization.Anti-VEGF drugs can be used as antagonists of VEGF antibody.Further they can inhibit neovascularization by stopping VEGF anyibody from binding to the relevant receptors.Therefore,this research is aiming to observe the curative effect of intravitreal conbercept(anti-VEGF drug)injections for pathologic myopia choroidal neovascularization in macular area.Objective: The article is aiming to observe the curative effect of intravitreal conbercept 0.05ml(0.5mg)injections for macular area choroidal neovascularization in pathologic myopia.Methods: The research used prospective study collected the patients with pathologic myopia choroidal neovascularization in macular area from December 2014 to August 2016.These patients was diagnosed active pathologic myopia choroidal neovascularization in macular area by fluorescein angiography and optical coherence tomography.These patients were randomly divided into 2 groups.The group 1 was defined the 1+prn.The patients of group 1 was received once intravitreal conbercept 0.05ml(0.5mg)injection in the primary treatment,1 weeks after injection,every month to the 6th month follow-up.The standard of reinjection was accorded to the fluorescein angiography and optical coherence tomography condition in follow-up.If there were one of following should received intravitreal reinjection again,such as persistent subretinal or/and retina liquid,the original disease expanded,new lesions generation in optical coherence tomography and leakage persists in fluorescein angiography.Every injection was should not be less than 1 months.The group 2 was defined the 3+prn.The patients of group 2 was received three times intravitreal conbercept 0.05ml(0.5mg)injection in the primary treatment,once a month,1 weeks after injection,every month to the 6th month follow-up.The standard of reinjection was identical with the group 1.In the end,the datum were analysed by the statistic software of IBM SPSS statistics 21.Results:1 The 25 patients(26 eyes)with active pathologic myopia choroidal neovascularization in macular area was collected from December 2014 to August 2016.These patients were randomly divided into 2 groups.The group 1 had 13 patients(13 eyes),3 men patients,10 women patients.The average age was 54 years.The average history,length of refractive errors was 35 years in group 1,the average diopter was-11 D,the average Log MAR BCVA was 0.9,the average intraocular pressure was 15.3mm Hg.The group 1 of the average retinal thickness under the choroidal neovascularization via optical coherence tomography was 447 ? m,the average size of the choroid neovascularization in the retina tomography was 0.18?m2.The average of self-reported symptoms time was 20 days in group 1,53.8% patients with metamorphopsy of the self-reported symptoms.The group 2 had 12 patients(13 eyes),1 men patients,11 women patients.The patients average age was 48 years.The average history,length of refractive errors was 32 years in group,the average diopter was-9D,the average Log MAR BCVA was 0.9,the average intraocular pressure was 15.3mm Hg.The group 1 of the average retinal thickness under the choroidal neovascularization at optical coherence tomography was 418?m,the average size of the choroid neovascularization in the retina tomography was 0.18?m2.The average of self-reported symptoms time was 21 days in group 1,69.2% patients with metamorphopsy of the self-reported symptoms.2 Observed to 6 months,the total injection times was 23 in group 1,the average injection times was 2,the minimum was 1,the maximum 3,among these patients had 5 eyes was received once intravitreal injection,6 eyes received 2 times intravitreal injection,2 eyes received 3 times intravitreal injection;the total injection times was 42 in group 1,the average injection times was 3,the minimum was 1,the maximum 5,among these patients had 11 eyes was received three times intravitreal injection,1 eyes received 4 times intravitreal injection,1 eyes received 5 times intravitreal injection.Observed to 6 months,two groups were entered cicatricial phase.In group 1 had 0 eye visual loss,there were 2 eyes vision unchanged,there were 11 eyes vision improved.In group 2 had 0 eye visual loss,there was 1 eye vision unchanged,there were 12 eyes vision improve.Observed to 6 months,the datum were analysed according to rank sum test and t-test by the statistic software of IBM SPSS statistics 21.The change of the retinal thickness uner the choroidal neovascularization at optical coherence tomography(Z=-3.186 P=0.001),the change of the size of the choroid neovascularization in the retina tomography(Z=-3.186 P=0.001),they had statistically significant(P<0.05)in group 1.The change of the retinal thickness uner the choroidal neovascularization at optical coherence tomography(Z=-3.180 P=0.000),the change of the size of the choroid neovascularization in the retina tomography(t=5.535 P=0.001),they had statistically significant(P<0.05)in group 2.Compared group 1 with group 2 the change of the retinal thickness uner the choroidal neovascularization at optical coherence tomography(Z=-0.333 P=0.739)and the size of the choroid neovascularization in the retina tomography(Z=-0.700 P=0.424)were no statistically significant(P>0.05).During the study period no patients of intraocular pressure were increased and no patients undergone severe complications.There were 3 patients experienced relapse during the study.Conclusions:1 Intravitreal conbercept 0.05ml(0.5mg)injections for pathologic myopia choroidal neovascularization in macular area is safe and effective.2 Regard to the patients with pathologic myopia choroidal neovascularization in macular area,there are no difference between received once and three times intravitreal conbercept 0.05ml(0.5mg)injection in primary treatment after on-demand treatment.3 Regard to the patients with pathologic myopia choroidal neovascularization in macular area,optical coherence tomography can as a evaluation criterion for retreatment in follow-up. |
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