Clinical efficacy of conbercept combined with micropulse laser in patients with polypoidal choroidal vasculopathy

Objective To evaluate the clinical efficacy of conbercept combined with micropulse laser(MPL) in treating polypoidal choroidal vasculopathy (PCV). Methods In this prospective, randomized controlled trial conducted from February 2023 to April 2024, 52 patients (52eyes) with PCV at ### hospital were enrolled. Participants were randomized into a conbercept monotherapy group (27cases, 27eyes) and a combination treatment group (conbercept plus micropulse laser(MPL); 25cases, 25eyes). After an initial series of three intravitreal injections, all patients followed the Treat & Extend (T&E) protocol. Aqueous humor samples were collected before each of the first three injections, and cytokines levels were measured after the sample collection. The combined treatment group received a 577nm MPL application two weeks following the first injection. The best corrected visual acuity (BCVA) 、central macular thickness (CMT) and total macular volume (TMV) of each group were assessed monthly for three months. Results From the first to the third month post-injection, both treatment groups showed improvements in BCVA and reductions in CMT and TMV, with the combined treatment group demonstrating significantly greater improvements at each monthly evaluation (P < 0.05). Additionally, levels of aqueous humor cytokines, including VEGF-A, IL-5, MCP-1, and Ang-2, were significantly reduced in both groups. Reductions in VEGF-A and MCP-1 concentrations were positively correlated with improvements in BCVA, CMT, and TMV (P < 0.01). Conclusion Conbercept combined with MPL therapy demonstrates superior clinical efficacy compared to intravitreal injection of Conbercept alone in patients with PCV. Furthermore, changes in VEGF-A and MCP-1 levels may serve as predictive markers for improvements in visual acuity and retinal morphology in these patients.