Breakthrough in Macular Edema Treatment: Combined Conbercept and Laser Therapy Shows Promise

Could Combined Conbercept and Laser Therapy Revolutionize Macular Edema Treatment?

The efficacy of combining conbercept with laser therapy for treating macular edema in patients with diabetic retinopathy and retinal vein occlusion has been demonstrated in a recent retrospective study. The research, conducted at The First Hospital of Putian, analyzed data from 63 patients who received treatment between January 2022 and January 2025, providing valuable insights into potential improvements in clinical management strategies for these vision-threatening conditions.

Diabetic retinopathy and retinal vein occlusion represent two of the most common causes of vision loss and blindness in middle-aged and elderly individuals. Both conditions can lead to macular edema, where fluid accumulates in the central retina due to capillary endothelial injury, thickening of vascular basement membranes, retinal ischemia, and abnormal neovascularization. Traditional laser photocoagulation has been a mainstay treatment, but its limitations—including restricted treatment targets and potential irreversible retinal damage—have prompted researchers to investigate combination therapies that might yield better outcomes for patients with severe or recurrent macular edema. The emergence of anti-VEGF agents, particularly conbercept, has opened new therapeutic avenues that may complement conventional approaches by targeting the underlying molecular mechanisms of disease progression.

What Does the Study Design Reveal About Treatment Effectiveness?

The study divided patients into two groups: a control group receiving standard laser photocoagulation therapy (n=31) and an observation group receiving combined laser and conbercept treatment (n=32). Conbercept, a novel fusion protein that binds to VEGF-A, VEGF-B, and placental growth factor (PlGF), was administered via intravitreal injection once monthly for three months in the observation group. The researchers evaluated multiple outcomes, including clinical efficacy, symptom improvement times, best-corrected visual acuity (BCVA), retinal thickness measurements, and adverse reactions. The results revealed significant advantages for the combination approach across several parameters. The total effective rate in the observation group reached 96.88%, substantially higher than the 74.19% observed in the control group (P < 0.05). Furthermore, patients receiving conbercept experienced significantly faster resolution of fundus hemorrhage, exudate absorption, and macular edema improvement compared to those receiving laser therapy alone (P < 0.001 for all comparisons).

Visual acuity outcomes further reinforced the superiority of the combination approach. While both groups showed improvements in BCVA scores over time, the observation group demonstrated significantly better visual outcomes at both one month and three months post-treatment. Notably, the structural improvements paralleled the functional gains, with OCT measurements showing greater reductions in retinal thickness across all measured areas (foveal, superior, nasal, inferior, and temporal) in the observation group. These findings suggest that conbercept enhances the therapeutic effect of laser treatment by providing complementary mechanisms of action—while laser primarily seals leaking vessels through localized thermal effects, conbercept antagonizes pro-angiogenic factors to inhibit neovascularization and reduce vascular permeability at the molecular level. This synergistic effect appears particularly beneficial for patients with strong inflammatory responses or persistent edema.

The detailed analysis of retinal thickness measurements provides compelling evidence for the structural benefits of combination therapy. Before treatment, both groups had comparable retinal thickness measurements, with the fovea centralis averaging 426.38±60.86 μm in the control group and 424.46±62.08 μm in the observation group. Post-treatment, the observation group showed significantly greater reductions across all measured areas. The foveal thickness decreased to 265.43±29.14 μm in the observation group compared to 344.72±37.19 μm in the control group (P < 0.001). Similar patterns were observed in the superior, nasal, inferior, and temporal retinal regions, with the observation group consistently demonstrating more substantial improvements. These structural changes correlate with the enhanced visual outcomes and faster symptom resolution times observed in patients receiving combination therapy.

Are Efficacy Gains Achieved Safely?

Safety analysis revealed comparable adverse event profiles between the two groups, with no significant difference in the overall incidence of complications (12.90% in the control group versus 9.38% in the observation group, P > 0.05). The observed adverse events included ocular hypertension, increased secretions, and vitreous hemorrhage, but no cases of endophthalmitis or macular holes were reported in either group. This favorable safety profile suggests that adding conbercept to standard laser therapy does not substantially increase treatment-related risks, an important consideration for clinical implementation. The researchers noted that conbercept, as a domestically produced anti-VEGF drug in China, has demonstrated high safety and compliance in widespread clinical use, potentially offering a cost-effective alternative to imported medications for various retinal vascular diseases.

Despite these promising results, the study authors acknowledged several limitations that should inform interpretation of the findings. The single-center retrospective design and relatively small sample size may have introduced selection bias. Additionally, the three-month follow-up period does not allow for assessment of long-term visual outcomes or recurrence rates, which are particularly relevant for chronic conditions like diabetic retinopathy and retinal vein occlusion. The lack of stratified analysis for different types of RVO (central versus branch retinal vein occlusion) represents another limitation, as the response to treatment might vary depending on the specific pathological background. Could these differences in treatment response between various RVO subtypes influence personalized therapeutic approaches in clinical practice? Future research addressing these limitations through prospective, multicenter designs with larger sample sizes and longer follow-up periods would strengthen the evidence base for this combined treatment strategy.

The integration of anti-VEGF agents with traditional laser therapy represents an evolving paradigm in the management of macular edema. This study adds to a growing body of evidence suggesting that combination approaches may provide more comprehensive treatment by addressing both the structural and molecular aspects of retinal vascular diseases. As ophthalmologists continue to refine treatment protocols for patients with diabetic retinopathy and retinal vein occlusion, the potential for conbercept to enhance therapeutic outcomes while maintaining an acceptable safety profile merits further investigation. How might the implementation of such combination therapies affect treatment algorithms and clinical decision-making for patients with different severities or durations of macular edema? Would certain biomarkers help identify patients most likely to benefit from this approach, enabling more targeted intervention strategies?

How Was Laser Therapy Precisely Delivered?

An important aspect of the study methodology was the standardized approach to laser photocoagulation in both groups. The control group received carefully calibrated laser treatment with specific parameters: spot diameter of 50–200 μm, power of 200 mW, exposure time of 0.2 seconds, and spacing of 1 spot diameter between laser burns. For patients with diabetic retinopathy, panretinal laser photocoagulation was performed, while those with retinal vein occlusion received focal laser photocoagulation targeted to the lesion area. In all cases, the central 500 μm of the macula and areas within 2 papillary diameters of the optic disc were avoided to preserve central vision and major retinal vessels. The observation group received identical laser treatment plus intravitreal injections of 0.05 mL conbercept administered once monthly for three consecutive months. This standardized approach strengthens the validity of the comparison between the two treatment modalities.

Could These Findings Shape Future Clinical Practice?

In conclusion, this retrospective analysis provides valuable insights into the potential benefits of combining conbercept with laser therapy for macular edema secondary to diabetic retinopathy and retinal vein occlusion. The observed improvements in clinical efficacy, symptom resolution time, visual acuity, and retinal thickness, coupled with a favorable safety profile, suggest that this approach warrants consideration in clinical practice. As research continues to evolve in this field, the development of individualized treatment protocols based on patient characteristics and disease features may further optimize outcomes for those affected by these vision-threatening conditions. What long-term impact might earlier and more effective resolution of macular edema have on preserving retinal function and preventing irreversible visual impairment in these patient populations? The answer to this question could fundamentally reshape treatment goals and expectations in the management of retinal vascular diseases.

Summary

The study, analyzing 63 patients over three years, compared traditional laser photocoagulation therapy against a combined approach using conbercept and laser treatment. The combination therapy group showed remarkably better results, with a 96.88% effectiveness rate compared to 74.19% in the control group. Patients receiving the combined treatment experienced faster resolution of symptoms, better visual acuity outcomes, and greater reductions in retinal thickness. The safety profile remained comparable between both groups, with no significant increase in complications. While the study showed promising results, limitations including its single-center design and short follow-up period suggest the need for more comprehensive research to fully validate these findings.