From the Fondazione G. B. Bietti-IRCCS, Rome, Italy.
Retina. 2010 Jul-Aug;30(7):1017-24. doi: 10.1097/IAE.0b013e3181cfd3c6.
The purpose of this study was to assess long-term functional and structural retinal changes in patients with neovascular age-related macular degeneration treated with intravitreal 0.5 mg ranibizumab.
Eighteen patients with neovascular age-related macular degeneration have been evaluated in this retrospective 24-month follow-up study. All patients have been treated with 3 injections of 0.5 mg ranibizumab 1 month apart and retreated according to predefined criteria. At baseline, all patients were subjected to visual acuity, fluorescein angiography, MP1 microperimetry, and Stratus optical coherence tomography. Although visual acuity and optical coherence tomography were repeated 28 +/- 2 days after each injection, MP1 was performed at 6, 12, and 24 months.
Seventeen of 18 and 14 of 18 patients completed 12 and 24 months of follow-up, respectively. Mean retinal sensitivity significantly improved from 3.89 +/- 3.0 dB to 7.33 +/- 4.11 dB at 24 months (P = 0.024). Mean visual acuity improved from 48.67 +/- 8.59 to 59.17 +/- 16.45 at 24 months (P = 0.049). Visual acuity improved to >or=15 letters in 33.3% (6 of 18) of patients and <15 letters in 44.4% (8 of 18); 22.2% (4 of 18) of patients lost <15 letters at 24 months. Five of 13 patients (38.5%) with either an instable or relatively instable fixation at baseline showed improvement of fixation stability at 24 months. Central retinal thickness significantly decreased from 310.5 +/- 85.7 to 232.9 +/- 60.1 at 24 months (P = 0.0001).
Intravitreal injections of 0.5 mg ranibizumab determine progressive improvement of retinal sensitivity until 24 months, although visual acuity levels off after 6 months, suggesting that microperimetry may give additional information about macular function not given by visual acuity alone.
本研究旨在评估玻璃体内注射 0.5mg 雷珠单抗治疗新生血管性年龄相关性黄斑变性患者的长期功能和结构视网膜变化。
本回顾性 24 个月随访研究纳入了 18 例新生血管性年龄相关性黄斑变性患者。所有患者均接受了 3 次 0.5mg 雷珠单抗注射，间隔 1 个月，根据预设标准进行再治疗。基线时，所有患者均接受了视力、荧光素血管造影、MP1 微视野和 Stratus 光相干断层扫描。尽管在每次注射后 28±2 天重复进行视力和光学相干断层扫描，但在 6、12 和 24 个月时进行 MP1 检查。
18 例患者中有 17 例和 18 例中有 14 例分别完成了 12 个月和 24 个月的随访。24 个月时，视网膜敏感度从 3.89±3.0dB 显著提高至 7.33±4.11dB（P=0.024）。视力从 48.67±8.59 提高至 59.17±16.45（P=0.049）。24 个月时，33.3%（6 例）患者的视力提高到≥15 个字母，44.4%（8 例）患者的视力提高到<15 个字母；22.2%（4 例）患者在 24 个月时丢失<15 个字母。13 例基线时固视不稳定或相对不稳定的患者中有 5 例（38.5%）在 24 个月时固视稳定性得到改善。24 个月时中央视网膜厚度从 310.5±85.7 显著降低至 232.9±60.1（P=0.0001）。
玻璃体内注射 0.5mg 雷珠单抗可使视网膜敏感度持续提高，直至 24 个月，但 6 个月后视力水平趋于稳定，这表明微视野检查可能提供比单纯视力检查更多的关于黄斑功能的信息。
