临床眼科杂志2026，Vol.34Issue(4)：289-296,8.DOI:10.3969/j.issn.1006-8422.2026.04.001
泛黄斑区阈值下微脉冲激光联合康柏西普治疗糖尿病性黄斑水肿后的黄斑区血流变化
Changes in macular blood flow density after Conbercept combined with pan-macular subthreshold micro-pulse laser for diabetic macular edema
摘要
Abstract
Objective To investigate changes in macular blood flow density after Conbercept combined with pan-macular subthreshold micropulse laser in the treatment of diabetic macular edema(DME).Methods This prospective randomized controlled study enrolled patients who were diagnosed with DME at the Department of Ophthalmology in the Second People's Hospital of Hefei from January 2022 to December 2024.Patients were randomized to the Conbercept monotherapy group or the pan-macular subthreshold micropulse laser(SMPL)combined with Conbercept group.The best-corrected visual acuity(BCVA),central macular thickness(CMT),and optical coherence tomography angiography param-eters,including superficial capillary plexus vessel density(SCPVD),deep capillary plexus vessel density(DCPVD),and fo-veal avascular zone(FAZ)area were compared at baseline and at 3 and 6 months after the treatment.The numbers of intra-vitreal injections and SMPL treatments during the 6-month follow-up were recorded.Statistical analyses included the independent-sample t test,chi-square test,repeated-measures analysis of variance with LSD-t post hoc comparisons,and the Mann-Whitney U test.Results Forty-five patients(56 eyes)were enrolled,including 20 males(26 eyes)and 25 fe-males(30 eyes).The monotherapy group included 24 patients(30 eyes),and the combination group included 21 patients(26 eyes).There was no significant difference in baseline characteristics between the two groups(all P＞0.05).At 3 and 6 months after the treatment,logMAR BCVA improved significantly in both groups(all P＜0.05),reaching 0.58±0.31 and 0.55±0.32 in the combination group and 0.63±0.23 and 0.61±0.27 in the monotherapy group,respectively.There were no significant differences between groups(all P＞0.05).CMT decreased significantly in both groups(all P＜0.05),reaching(305.51±74.62)μm and(283.51±62.08)μm in the combination group and(328.23±84.58)μm and(312.51±86.85)μm in the monotherapy group,respectively.There were no significant differences between groups(all P＞0.05).FAZ area de-creased significantly in both groups(all P＜0.05),reaching(0.38±0.08)mm2 and(0.35±0.08)mm2 in the combination group and(0.42±0.11)mm2 and(0.37±0.09)mm2 in the monotherapy group,respectively.There were no significant differences be-tween groups(all P＞0.05).SCPVD-T4 in the monotherapy group decreased significantly from baseline at both 3 and 6 months after the treatment(all P＜0.05).At 6 months after the treatment,DCPVD-T3 in the combination group increased sig-nificantly from baseline,whereas DCPVD-T4 in the monotherapy group decreased significantly from baseline(all P＜0.05).The monotherapy group received 4(3,4)intravitreal injections,whereas the combination group received 3(3,4)injections.The number of injections was significantly lower in the combination group(P＜0.05).The number of SMPL treatments in the combination group was 1(1,2).No severe systemic or ocular adverse events occurred during follow-up.Conclusions Pan-macular subthreshold micropulse laser combined with Conbercept is effective and safe for treating DME.Compared with Conbercept monotherapy,the combination treatment reduces the number of intravitreal injections and helps maintain and improve retinal capillary plexus perfusion.关键词
糖尿病视网膜病变/黄斑水肿/激光凝固术/康柏西普/相干光层析血管成像术Key words
Diabetic retinopathy/Macular edema/Laser coagulation/Conbercept/Optical coherence tomography angiography引用本文复制引用
魏科,纪风涛,王慧,李永蓉,刘广源,戴维,廖荣丰..泛黄斑区阈值下微脉冲激光联合康柏西普治疗糖尿病性黄斑水肿后的黄斑区血流变化[J].临床眼科杂志,2026,34(4):289-296,8.基金项目
合肥市卫生健康应用医学研究项目(Hwk2022zd008) （Hwk2022zd008）
合肥市第二人民医院科研项目(2022yzd002) （2022yzd002）
