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光动力疗法联合雷珠单抗治疗息肉状脉络膜血管病变:一项为期 1 年的初步研究结果。

Photodynamic therapy combined with ranibizumab for polypoidal choroidal vasculopathy: results of a 1-year preliminary study.

机构信息

Department of Ophthalmology, Faculty of Medicine, Rajavithi Hospital, Rangsit University, Bangkok 10400, Thailand.

出版信息

Br J Ophthalmol. 2010 Aug;94(8):1045-51. doi: 10.1136/bjo.2009.173120. Epub 2010 Jun 8.

Abstract

BACKGROUND/AIMS: To determine the potential efficacy and safety of combined verteporfin photodynamic therapy (PDT) with ranibizumab for the treatment of polypoidal choroidal vasculopathy (PCV).

METHODS

In this prospective, non-comparative, interventional study, 12 eyes from 12 patients that had active PCV were treated with PDT combined with three monthly intravitreal injections of ranibizumab. The patients were then monitored monthly with measurements of best-corrected visual acuity (BCVA) and central retinal thickness quantified by optical coherence tomography for 1 year. Indocyanine green angiography (ICGA) and fluorescein angiography were performed every 3 months. The eyes were re-treated with PDT and a ranibizumab injection, or with solely ranibizumab injection when indicated.

RESULTS

At month 12, the mean BCVA change from baseline was +12.3 letters (p=0.04). Eight patients (58.3%, p=0.02) had a BCVA gain of 15 letters or more. One patient (8.3%, p=1.0) had a BCVA loss of 15 letters or more. All patients underwent regression of polyps without recurrence. One patient experienced an insignificant subretinal haemorrhage. No other adverse event that could be attributed to the treatment was observed.

CONCLUSIONS

This combination therapy showed encouraging results concerning improving vision, reducing the incidence of subretinal haemorrhage and reducing the recurrence of polyps when compared to previously published data that reported PDT monotherapy for PCV.

摘要

背景/目的:确定联合维替泊芬光动力疗法(PDT)与雷珠单抗治疗息肉状脉络膜血管病变(PCV)的潜在疗效和安全性。

方法

在这项前瞻性、非对照、干预性研究中,12 例活动性 PCV 患者的 12 只眼接受 PDT 联合每月三次玻璃体内注射雷珠单抗治疗。然后,通过最佳矫正视力(BCVA)和光学相干断层扫描定量中央视网膜厚度的测量,每月监测患者 1 年。每 3 个月进行吲哚青绿血管造影(ICGA)和荧光素血管造影检查。当需要时,通过 PDT 和雷珠单抗注射或单独雷珠单抗注射对眼睛进行再治疗。

结果

在第 12 个月,与基线相比,平均 BCVA 变化为+12.3 个字母(p=0.04)。8 名患者(58.3%,p=0.02)的 BCVA 增益达到 15 个字母或更多。1 名患者(8.3%,p=1.0)的 BCVA 损失达到 15 个字母或更多。所有患者的息肉均消退且无复发。1 名患者出现轻微的视网膜下出血。未观察到可归因于治疗的其他不良事件。

结论

与之前报道的 PDT 单药治疗 PCV 的数据相比,这种联合治疗在改善视力、减少视网膜下出血的发生和减少息肉的复发方面显示出令人鼓舞的结果。

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