Conbercept and Retinal Photocoagulation in the treatment of Diabetic Macular Edema

From Monotherapy to Combination Strategies: Redefining Treatment Approaches for Multiple-Cause Macular Edema

Macular edema (ME) is a leading cause of visual impairment in various retinal disorders. Current treatment modalities, including anti-vascular endothelial growth factor (anti-VEGF) agents and corticosteroids, often require repeated applications, increasing both medical and economic burdens. ME is driven by chronic inflammation and VEGF overexpression, causing fluid accumulation in the macula. Recent studies have highlighted the role of various cytokines in ME pathogenesis, necessitating a comprehensive approach to treatment. While monotherapies have shown efficacy, they are associated with limitations such as the need for frequent injections and potential side effects. Combination therapies, including anti-VEGF drugs with macular laser photocoagulation, triamcinolone acetonide, or dexamethasone intravitreal implant (Ozurdex), have emerged as promising strategies. This review analyzes the outcomes of various combination approaches in different types of ME, including diabetic macular edema (DME), retinal vein occlusion-associated ME (RVO-ME), and uveitic macular edema (UME). The potential benefits of combining anti-VEGF and anti-inflammatory treatments are discussed, along with the need for personalized treatment regimens. Future research directions are outlined, emphasizing the importance of large-scale, long-term studies to evaluate the sustained efficacy and safety of combination therapies. The integration of advanced imaging techniques, biomarker analysis, and innovative therapeutic approaches is expected to shape the future landscape of ME management, moving towards more targeted and effective combination therapies.

Conbercept combined with laser photocoagulation in the treatment of diabetic macular edema and its influence on intraocular cytokines

BACKGROUND

The prevalence of diabetes mellitus (DM) in China is high, and the base is broad. Diabetic retinopathy (DR) is a critical condition affecting the life and health of a nation and its economic development. DR is a common complication of DM.

AIM

To investigate the efficacy of laser photocoagulation combined with intravitreal injection of conbercept for treating macular edema.

METHODS

Overall, 130 patients with diabetic macular edema (DME) hospitalized in The Third People's Hospital of Changzhou from January 2019 to June 2022 were retrospectively included. According to the treatment plan, 130 patients with DME were categorized into an observation and a control group, with 65 patients in each group. The control group received laser photocoagulation, and the observation group received laser photocoagulation with intravitreal injection of conbercept. Observe changes in vision, cytokines in the eye and so on.

RESULTS

The total efficacy rate in the observation group (93.85%) was higher than that in the control group (78.46%) (P < 0.05). In both groups, the best corrected visual acuity correction effect improved after treatment, and the observation group was superior to the control group (P < 0.05). Retinal thickness and central macular thickness improved after treatment, and the observation group was superior to the control group (P < 0.05). The levels of vascular endothelial growth factor, interleukin-6, soluble intercellular adhesion molecule-1, and basic fibroblast growth factor in both groups improved after treatment, and the observation group was superior to the control group (P < 0.05).

CONCLUSION

In patients with macular edema, combining laser photocoagulation and intravitreal injections of conbercept for DME is a more effective and safer strategy to improve vision, and lower intraocular cytokine levels.

Intravitreal injection of Conbercept combined with micropulse laser therapy enhances clinical efficacy in patients with diabetic macular edema

PURPOSE

To analyze the clinical efficacy of intravitreal injection of Conbercept (IVC) combined with micropulse laser (MPL) therapy in the treatment of diabetic macular edema (DME).

METHODS

In this retrospective study, we selected 64 DME patients who visited the First People's Hospital of Yunnan Province between February 2019 and February 2021 for analysis. Based on different intervention methods, 31 cases treated with IVC were included as a control group (the Con group) and 33 cases with IVC + MPL combination therapy were in a research group (the Res group). Data on curative effects, injection frequency, pre- and post-treatment best corrected visual acuity (BCVA) and central macular thickness (CMT), visual field gray value, 30° visual field average light threshold sensitivity, and mean visual field defect (VFD) were collected for inter-group comparisons. Further, Cox multivariate regression analysis was performed to identify factors affecting the curative efficacy of DME patients.

RESULTS

Compared with the Con group, the Res group had a higher total response rate and a lower injection frequency. In addition, higher BCVA and lower CMT were determined in the Res after 6 months of treatment. Moreover, Res group exhibited statistically lower visual field gray value and mean VFD, as well as higher 30° visual field average light threshold sensitivity than the Con at 1 month postoperatively. All the above differences were statistically significant. According to the Cox multivariate regression analysis, treatment modality was the influencing factor for the efficacy of DME patients.

CONCLUSIONS

IVC + MPL have better clinical efficacy than IVC alone for DME. The combined modality can improve patients' visual quality, inhibit DME, and reduce medication frequency.

Efficacy of intravitreal conbercept combined with panretinal photocoagulation for severe nonproliferative diabetic retinopathy without macular edema

AIM

To assess efficacy of intravitreal conbercept (IVC) injection in combination with panretinal photocoagulation (PRP) vs PRP alone in patients with severe nonproliferative diabetic retinopathy (SNPDR) without macular edema (ME).

METHODS

Forty-eight patients with SNPDR without ME (56 eyes) were divided into the PRP group and IVC+PRP group (the pulse group) in this retrospective clinical study. Conbercept was intravitreally administered to patients in the pulse group 1wk before treatment with PRP and followed up for 1, 3, and 6mo. The best-corrected visual acuity (BCVA, logMAR), center foveal thickness (CFT), visual acuity (VA) improvement, and adverse reactions were compared between groups.

RESULTS

In the PRP group, the BCVA reduced at 1 and 3mo before improving at 6mo. In the pulse group, baseline BCVA decreased continuously at 1mo, increased at 3 and 6mo. BCVA in the pulse group was better than that in the PRP group at 1, 3, and 6mo. There was an increase in CFT in the PRP group during follow-up compared with baseline. In the pulse group, CFT was increased at 1mo relative to baseline, steadily decreased to the baseline level at 3 and 6mo. There was a more significant reduction in CFT in the pulse group during follow-up compared with the PRP group. The effective rates of VA in the PRP and the pulse groups were 81.48% and 100%, respectively.

CONCLUSION

As PRP pretreatment, a single dose of IVC administration has beneficial effects for preventing PRP-induced foveal thickening and increasing VA in patients with SNPDR without ME.

Conbercept for Treatment of Neovascular Age-Related Macular Degeneration and Visual Impairment due to Diabetic Macular Edema or Pathologic Myopia Choroidal Neovascularization: A Systematic Review and Meta-Analysis

Background: Conbercept is a new anti-vascular endothelial growth factor (VEGF) drug. Here, we systematically conducted the efficacy, safety, compliance, and pharmacoeconomic evaluation of intravitreal conbercept (IVC) compared with other treatments in patients with neovascular age-related macular degeneration (nAMD), diabetic macular edema (DME), or pathologic myopia choroidal neovascularization (pmCNV). Methods: Databases of PubMed, Embase, Cochrane Library, ClinicalTrials.gov, SinoMed, China National Knowledge Infrastructure, and WanFang Data were systematically searched from the inception to July 27, 2021. Randomized clinical trials and pharmacoeconomic studies comparing IVC with control groups in adults with nAMD, DME, or pmCNV were reviewed and selected. Meta-analyses were performed using the fixed-effects model when pooled data were homogeneous. Heterogeneous data were analyzed using the random-effects model. Primary outcomes included visual improvement rate, mean change in visual acuity or best corrected visual acuity, and pharmacoeconomic outcomes. Additional outcomes were the mean change in fundus examination values, adverse events (AEs), quality-of-life measures, and number of injections. Results: Among 3,591 screened articles, 22 original studies with 1,910 eyes of patients were finally included. For nAMD and DME, IVC was significantly associated with better visual acuity or best corrected visual acuity improvement and fundus quantitative measures than placebo, laser photocoagulation (LP), or intravitreal triamcinolone acetonide (IVT). However, IVC showed non-inferior efficacy to intravitreal ranibizumab (IVR) according to low quality of evidence, and there was lack of trials comparing the priority of IVC to other anti-VEGF regimens. No definitive increased risk of ocular or non-ocular AEs were observed in the study groups. All patients with AEs recovered after symptomatic treatments, and no severe AEs occurred. Patients treated with IVC might have higher quality-of-life scores than those in IVR in nAMD or LP in DME. Additionally, IVC showed cost-utility advantages in nAMD and cost-effectiveness advantages than IVR in pmCNV in China. Conclusion: IVC is well-tolerated and effective for improving vision acuity and quantitative measures in fundus condition in patients with nAMD and DME compared with LP, IVT, and placebo, but gains comparable efficacy to IVR. However, well-designed, large-sample, and long-term evaluation of IVC shall be conducted in additional studies worldwide.

The Effectiveness of Conbercept Combined with Panretinal Photocoagulation vs. Panretinal Photocoagulation in the Treatment of Diabetic Retinopathy: A Meta-Analysis

Objective

This meta-analysis aimed to compare the effect and safety of conbercept with panretinal photocoagulation (PRP) vs. PRP in the treatment of diabetic retinopathy (DR).

Methods

Relevant studies were identified through systemic searches of PubMed, EMBASE, China National Knowledge Infrastructure, and Wanfang database up to December 2020. The results of conbercept and PRP in patients with DR were analyzed, including overall effectiveness, best corrected visual acuity, central macular thickness, and complications.

Results

12 articles involving 1244 patients with DR were identified for this meta-analysis. The results of the meta-analysis showed that conbercept combined with PRP significantly increased the level of overall effectiveness and significantly reduced the central thickness of macula and the incidence of complications compared with the control group.

Conclusions

Conbercept with PRP tended to be more effective than PRP alone in terms of functional outcomes for treating DR.