Evaluation Of Short-term Efficacy Of SD-OCT Combined With Mf-ERG In The Treatment Of Exudative Age-related Macular Degeneration By Conbercept

Objective:To observe three consecutive intravitreal injections of Conbercept in the treatment of exudative age-related macular degeneration(nAMD).To investigate the correlation between retinal anatomy and retinal function by spectral-domain optical coherence tomography(SD-OCT)and multifocal electroretinogram(mf-ERG),and to evaluate the short-term clinical efficacy of Conbercept in the treatment of nAMD.Also to explore the value of mf-ERG as a predictor of efficacy and optimal treatment regimens.Methods:This study retrospectively collected patients in the fundus clinic of the First Affiliated Hospital of Chongqing Medical University from June 2017 to December 2018.By the fundus examination,SD-OCT,fundus fluorescein angiography(FFA),indocyanine green angiography(ICGA),36 patients(36 eyes)diagnosed as nAMD were treated with intravitreal injection of Conbercept 0.05ml/0.5mg,once a month,3consecutive treatments.The best corrected visual acuity(BCVA),central retinal macular thickness(CRT),the volume of the RPE uplift in the 1 mm,3 mm,and 6 mm rounds of the macular center(1RV,3RV,6RV),and the amplitude density,latency data of P1 wave in mf-ERG R1 ring were recorded before and every month after treatment.The data was processed statistically by Spss 22 software.Paired t test was used to compare the difference between the two groups before and after treatment.Pearson correlation analysis was used to analyze the correlation between macular retinal structure and function.The difference was significant when P<0.05.Result:After 3 times of intravitreal injection,compared with before the first treatment,the average BCVA of 36 patients(36 eyes)increased(0.19±0.16 VS 0.34±0.24),the average CRT decreased(472.14±181.53?m VS 311.61±95.67?m),the average 1RV decreased(0.36±0.14 mm~3 VS0.25±0.08mm~3),theaverage3RVdecreased(3.04±0.98mm~3VS2.17±0.72mm~3),the average 6RV decreased(8.17±2.91 mm~3 VS4.9±2.49mm~3),and the difference was statistically significant(P<0.01).Compared with pre-treatment,the amplitude density of P1 wave increased from(36.47±14.25)nv/deg~2 to(58.36±13.45)nv/deg~2,the difference was statistically significant(P<0.01).And the latency data of P1 wave had no significant change(38.13±9.75ms vs 39.21±9.62ms),with no statistical significance(P>0.05).BCVA was negatively correlated with CRT,1RV,3RV and 6RV before and after operation,and positively correlated with the amplitude density and incubation period of P1 wave,while CRT,1RV,3RV and 6RV were negatively correlated with the amplitude density of P1 wave.Four cases of 4 eyes had subconjunctival hemorrhage after injection,2cases of 2 eyes had corneal epithelial damage,and all recovered to normal after treatment.The intraocular pressure of 36 eyes before and after treatment was in the normal range.There was no significant change before and after intraocular pressure,with no statistical significance(P>0.05).No serious ocular and systemic complications,such as uveitis,lens damage,vitreous hemorrhage,endophthalmitis,retinal detachment were found during the follow-up period.Conclusion:36 nAMD eyes were treated with intravitreal injection of Conbercept for 3 times.The results showed that the average BCVA increased by 2 to 3 lines after treatment,and the CRT,1RV,3RV,6RV,the P1 wave amplitude density of mf-ERG R1 ring were significantly improved compared with the first treatment,and there is a correlation between the changes.There were no obvious adverse reactions in 36 eyes during the treatment.Therefore,Conbercept is effective in the treatment of nAMD in short term.It can improve the visual acuity of the affected eyes,restore the structure and function of retina,and has high safety.BCVA,SD-OCT combined with mf-ERG are more objective and comprehensive in evaluating the therapeutic effect of nAMD.Mf-ERG is expected to be an objective functional indicator for evaluating efficacy and judging re-treatment during nAMD treatment.