| Objective:Comparing the therapeutic effects of two receptor fusion protein drugs,aflibercept and conbercept in the treatment of wet age-related macular degeneration.Methods:From January 2019 to January 2021,60 cases and 60 eyes of patients with wet age-related macular degeneration who were admitted and diagnosed in our hospital were selected for the study.The patients were divided into conbercept treatment group and aflibercept treatment group,30 cases and 30 eyes in each group.There is no statistically significant difference in general information between the two groups(P>0.05),and the group study can be carried out separately.All patients were treated with 3+PRN treatment plan.All patients were followed up for 1 year.All patients underwent best-corrected visual acuity,intraocular pressure,fundus examination,fundus fluoroscopy and macular OCT examination,and recorded adverse events and the number of injections.Observe the improvement of vision,whether there is neovascularization or leakage in the lesion,the thickness of the foveal retina,the average number of injections,and whether there is any significant difference in recurrence after the two drugs.Results:1.Follow-up within 1 year after treatment found that the vision of the patients in the Conbercept group was significantly improved and improved,a total of 15 cases(50%),and the improvement rate was 50.0%;a total of 12 cases(40%)had no significant change in vision compared with before.The visual acuity of 3 patients was significantly lower than before treatment.Among the patients treated with aflibercept,there were 18 cases(60%)with improved or improved vision,and a total of 9 cases(30%)with no obvious change in vision;the same 3 patients experienced further decline in vision after treatment;two There was no statistically significant difference in visual acuity improvement between the two groups(P>0.05).2.The total number of injections within 1 year of the two groups of patients,the average number of injections of the conbercept treatment group was 3.3 times,and the total number of injections was 101 times.Among them,4 cases had recurrence and were administered on-demand for a total of 5 times,3 patients The patient received an additional injection.In 3 cases,the macular OCT was ineffective and increased exudation after 5 injections.The injection was stopped and regular review was arranged.In the aflibercept treatment group,the average number of drug injections was 3.1 times,and the total number of injections was 95 times.One case had 5 injections,and 3 patients received additional injections as needed in the later period.Among them,2 cases had 4 injections and reviewed macular OCT.It was shown to be invalid and the leakage was further aggravated,so the injection was stopped for regular review.There was no significant difference in the number of injections between the two groups(P>0.05).3.The thickness of the fovea in the macular area before treatment in the Conbercept group was(328.2 ± 35.33)um,and the thickness of the macular area was reduced to(265.1 ± 29.26)um after 6 to 12 months after treatment,and the retinal thickness in the macular area was higher than that before the treatment.The average drop was 63.1um,and the difference in CMT changes before and after intravitreal injection was statistically significant(P <0.05),P=0.000.The macular retinal thickness in the aflibercept group was(324.6±42.05)um before treatment.After 6 to12 months of treatment,the macular thickness decreased to(259.9±35.01)um,and the macular retinal thickness decreased by an average of 64.6 um,the difference in CMT regression after treatment was also statistically significant(P <0.05),P=0.000.There was no statistically significant difference between the two groups before and after the treatment of the decrease in CMT after treatment(P>0.05).4.After a complete course of treatment in the Conbercept group,FFA examination found that: 12 cases(40%)of leakage basically subsided <10%,and 10cases(33.33%)of leakage area decreased by ≥50% compared to before treatment,3cases(10.0%)of leakage persisted,a decrease of <50% compared to the previous case,3 cases(10.0%)of the leakage could not be controlled,the original area of the leakage was significantly enlarged,and 2 cases(6.66%)had re-leakage or new Leakage point.The total improvement rate of drug leakage control was 73.33%.After a course of treatment in the aflibercept group,FFA was performed: 15 cases(50%)had leakage disappeared <10%,8 cases(26.66%)had a leakage area reduction of ≥50% compared to before treatment,and 3 cases(10.0%))Leakage continued,2 cases(6.66%)of macular area leakage could not be controlled,the original leakage area was significantly enlarged,and 2 cases(6.66%)had re-leakage areas or new leakage points.The total improvement rate of leakage after drug treatment was 76.66%.There was no statistically significant improvement in macular leakage between the two groups of patients after IVT drug treatment(P>0.05).5.After 6 months of drug treatment in the Conbercept group,14 cases had improved vision and CNV subsided significantly.10 cases had stable vision and decreased CMT thickness with an average of 29.2um,and the effective rate of treatment reached 80%(24/30).After 6 months of drug treatment in the chypre group,the vision of 16 patients was significantly improved and the CNV disappeared,10 cases had stable vision and the CMT thickness subsided to 35.0um,and the effective rate of treatment reached 86.6%(26/30).There was no difference in the effective rate of the two groups of drugs.Statistically significant(P>0.05).6.In the follow-up of 60 patients with 60 eyes in this study,8 patients(13.3%)had mild eye pain and foreign body sensation after operation,and 4 patients(6.6%)had red eyes with subconjunctival hemorrhage,none of them were given After special treatment,the patient’s symptoms were relieved one day later,and the above symptoms completely disappeared in two days.None of the patients had any adverse events such as eye infection,postoperative high intraocular pressure,retinal detachment or cataract.Conclusion:1.The two receptor fusion protein drugs,aflibercept and conbercept,have similar effects on wet age-related macular degeneration.2.Both types of vitreous injection drugs can be treated with 3+PRN regimen. |
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