Parravano Mariacristina, Oddone Francesco, Tedeschi Massimiliano, Schiano Lomoriello Domenico, Chiaravalloti Adele, Ripandelli Guido, Varano Monica
Fondazione G.B. Bietti-IRCCS, Rome, Italy.
Retina. 2009 Mar;29(3):329-34. doi: 10.1097/IAE.0b013e31819093e6.
To assess functional and structural retinal changes in patients with neovascular age-related macular degeneration treated with intravitreal ranibizumab 0.5 mg.
Eighteen patients with neovascular age-related macular degeneration have been evaluated in this retrospective 24-week follow-up study. All patients were treated with three injections of ranibizumab 0.5 mg, 1 month apart and retreated according to predefined criteria. At baseline, all patients were subjected to visual acuity measurement, fluorescein angiography, microperimetry, and optical coherence tomography stratus. Visual acuity, microperimetry, and optical coherence tomography evaluations were repeated 28 +/- 2 days after each injection.
Mean retinal sensitivity significantly improved from 3.89 +/- 3.0 dB at baseline to 6.61 +/- 3.4 dB at 24 weeks (P = 0.044). Mean visual acuity significantly improved from 48.67 +/- 8.58 to 60.72 +/- 16.09 (P = 0.026); visual acuity improved in 44.4% of patients > or =15 letters (24.5 +/- 8.0 letters), and in 38.9% of patients improved <15 letters (6.14 +/- 3.7 letters); 16.7% of patients lost <15 letters (7.3 +/- 2.1 letters). An improvement of fixation stability from baseline was observed in 33.3% of patients. Central macular thickness significantly decreased from 310.5 +/- 85.7 microm to 217.3 +/- 46.8 microm at 24 weeks (P < 0.001).
Although visual acuity and retinal thickness changes seemed to be almost maximum at 4 weeks after intravitreal ranibizumab 0.5 mg, retinal sensitivity as measured by microperimetry showed a trend of progressive improvement till 24 weeks suggesting that microperimetry may give additional information about macular function not given by visual acuity alone.
评估接受玻璃体内注射0.5毫克雷珠单抗治疗的新生血管性年龄相关性黄斑变性患者视网膜的功能和结构变化。
在这项回顾性24周随访研究中，对18例新生血管性年龄相关性黄斑变性患者进行了评估。所有患者均接受3次0.5毫克雷珠单抗注射，每次间隔1个月，并根据预定义标准进行再次治疗。基线时，所有患者均接受视力测量、荧光素血管造影、微视野检查和光学相干断层扫描。每次注射后28±2天重复进行视力、微视野检查和光学相干断层扫描评估。
平均视网膜敏感度从基线时的3.89±3.0分贝显著提高至24周时的6.61±3.4分贝（P = 0.044）。平均视力从48.67±8.58显著提高至60.72±16.09（P = 0.026）；44.4%的患者视力提高≥15个字母（24.5±8.0个字母），38.9%的患者视力提高<15个字母（6.14±3.7个字母）；16.7%的患者视力下降<15个字母（7.3±2.1个字母）。33.3%的患者观察到注视稳定性较基线有所改善。中心黄斑厚度在24周时从310.5±85.7微米显著降至217.3±46.8微米（P < 0.001）。
尽管在玻璃体内注射0.5毫克雷珠单抗后4周时视力和视网膜厚度变化似乎几乎达到最大值，但通过微视野检查测量的视网膜敏感度在24周前呈逐渐改善趋势，这表明微视野检查可能提供仅靠视力无法获得的有关黄斑功能的额外信息。
