Ernst Benjamin J, Barkmeier Andrew J, Akduman Levent
Saint Louis University Eye Institute, 1755 S Grand Blvd.,St. Louis, MO 63104, USA.
Int Ophthalmol. 2010 Jun;30(3):267-70. doi: 10.1007/s10792-009-9324-9.
To evaluate optical coherence tomography (OCT)-based intravitreal ranibizumab treatment for neovascular age-related macular degeneration (AMD), the charts of consecutive patients who received intravitreal ranibizumab for subfoveal choroidal neovascularization due to AMD were retrospectively reviewed. Patients with less than 6 months follow-up were excluded. OCT was performed at baseline and at monthly intervals for induction therapy. Injections were given monthly until no improvement was observed between successive OCTs. In the maintenance period, reinjections were performed for any recurrence of macular fluid on OCT. Main outcome measures were visual acuity and number of injections given. Twenty-five eyes of 22 patients with mean follow-up of 16 months [standard deviation (SD) = 3.7 months] had mean improvement of 1.6 lines of Snellen visual acuity (SD 2.9, 95% confidence interval 0.48-2.9, P = 0.008). Visual acuity was stable (< or =3 lines of visual acuity lost) in 22 eyes (88%). Nine eyes (36%) gained > or =3 lines. Three eyes (12%) lost > or =3 lines. A mean of 6.0 (SD 2.7) injections were given over a follow-up period ranging from 8 to 21 months. We conclude that OCT-based intravitreal ranibizumab treatment for neovascular AMD offered excellent visual acuity results and reduced the number of injections compared with monthly dosing.
为评估基于光学相干断层扫描(OCT)的玻璃体内注射雷珠单抗治疗新生血管性年龄相关性黄斑变性(AMD)的效果,我们回顾性分析了因AMD导致的黄斑下脉络膜新生血管而接受玻璃体内注射雷珠单抗治疗的连续患者的病历。排除随访时间少于6个月的患者。在基线期及诱导治疗期间每月进行一次OCT检查。每月注射一次,直至连续两次OCT检查未发现病情改善。在维持期,若OCT检查发现黄斑区积液复发,则再次进行注射。主要观察指标为视力和注射次数。22例患者的25只眼平均随访16个月[标准差(SD)=3.7个月],Snellen视力平均提高1.6行(SD 2.9,95%置信区间0.48 - 2.9,P = 0.008)。22只眼(88%)的视力稳定(视力下降≤3行)。9只眼(36%)视力提高≥3行。3只眼(12%)视力下降≥3行。在8至21个月的随访期内,平均注射6.0次(SD 2.7)。我们得出结论,与每月给药相比,基于OCT的玻璃体内注射雷珠单抗治疗新生血管性AMD可提供优异的视力结果并减少注射次数。