| OBJECTIVE To compare the effectiveness of Conbercept combined with 577nm subthreshold micropulse laser and Conbercept monotherapy in the treatment of Diabetic Macular Edema(DME)from three aspects of the number of injections,visual acuity and macular structure index.To evaluate whether combined therapy can reduce the number of injections of Conbercept and whether there are differences between the two methods in improving Diabetic Macular Edema and visual acuity,so as to provide a new treatment for the clinical treatment of DME.METHODS A prospective randomized controlled clinical study.From June 2016 to June 2017,68 eyes of 68 patients with DME diagnosed in Central Theater Command general hospital of the Chinese People,s Liberation Army were enrolled in the study.The patients were randomly assigned to two different treatment groups:36 eyes(36 patients)in the Conbercept combined with 577nm subthreshold micropulse lase group(Combined treatment group)and 32 eyes(32 patients)in Conbercept group(Trug treatment group.All patients received three initial intravitreous injection of Conbercept and re-treatment was performed according to the criteria which has been disigned before.BCVA was measured by Early Treatment Diabetic Retinopathy Study charts.The Central Macular Thickness(CMT),Total Macular Volume(TMV)were measured by Topcon 3D-OCT 2000.The BCVA,CMT and TMV in the combined treatment group and the Trug treatment group were(57.9±12.4)letters,(427.8±129.4)um,(10.14±1.50)mm3 and(59.0±16.0)letters,(441.0±135.7)um,(10.43±2.10)mm3 respectively.There was no significant difference(t=0.321,0.410,0.641,P=0.749,0.683,0.524).The follow-up period was more than 12 months.The changes of BCVA,CMT and TMV were compared between the two groups.Comparison of BCVA,CMT,TMV before and after treatment in and between groups using repeated measures analysis of variance.Results The average annual injection times was(5.8±1.9)in Combined treatment group and(8.5±2.4)in Trug treatment group.The difference was significant(t=5.12,P=0.000).The BCVA in the 3rd,6th,9th and 12th month were(64.9±11.1),(65.66±10.5),(67.0±10.8),(66.6±10.7)letters and(65.7±15.8),(66.9±15.7),(66.4±13.0),(67.3±16.4)letters respectively,and there were significant differences compared with BCVA before treatment(F=34.234,10.137,P=0.000,000).The CMT were(335.2±105.9),(352.6±106.6),(336.21120.8),(305.9±97.0)um and(323.9±92.8),(325.5±90.2),(327.6±108.2),(312.2±106.8)um respectively.The TMV were(9.20±1.08),(9.26±1.20),(9.20±1.63),(9.05 ±1.18)mm3 and(9.19±1.21),(9.35±1.69),(9.09±1.20),(8.92±1.10)mm3,respectively.Compared with the CMT and TMV before treatment,the differences were statistically significant(FCMT=12.152,12.917,FTMV=11.198,11.008;P=0.000,0.000,0.000,0.000).There was no significant difference in BCVA,CMT and TMV between the two groups at different time points after treatment(F = 0.049,0.074,0.009,P = 0.826,0.786,0.925).Conclusion 1.Conbercept combined with 577nm subthreshold micropulse laser treatment can reduce the number of injection of Conbercept in the treatment of diabetic macular edema;2.Both the combination treatment group and the Conbercept monotherapy Trug treatment group can effectively improve the BCVA of the patient,.There was no significant difference between the two groups.3.Both the combination therapy group and the Conbercept monotherapy group could effectively reduce CMT and TMV in DME patients and reduce macular edema.There was no statistical difference between the two groups. |
