Ouhadj O, Bouarfa A, Akel S, Mendil L, Nebab A, Nouri M T
Service d'ophtalmologie, CHU Béni-Messous, Alger, Algérie.
J Fr Ophtalmol. 2010 Nov;33(9):649-54. doi: 10.1016/j.jfo.2010.09.004. Epub 2010 Nov 2.
Macular choroidal neovascularization (CNV) is a serious complication of high myopia, compromising the visual prognosis in young patients. The purpose of this study was to evaluate the safety and efficacy of first-line intravitreal ranibizumab in the treatment of myopic CNV.
We conducted a single-center prospective, consecutive, interventional study of patients with subfoveal or juxtafoveal CNV secondary to pathologic myopia (PM) treated with intravitreal injection of ranibizumab in the Beni-Messous University Hospital from January 2009 to April 2010. Best-corrected visual acuity (BCVA), fundus examination, optical coherence tomography (OCT), and fluorescein angiography (FA) were performed at baseline and monthly for all patients. Indications for retreatment were persistence or recurrence of the neovascular activity.
The study included 40 eyes of 40 patients, 33 of whom were females (82.5%), with a mean age of 40.22 ± 10.81 years (range, 20-55 years), with visual acuity between 1/100 and 1/10. The mean spherical equivalent refractive error was -14.13 ± 4.65 diopters (range, -7 D to -23 D). The mean follow-up time was 8 months (range, 3-15 months). The mean number of intravitreal injections administered for each patient was 2.2 (range: 1-4). Follow-up ranged from 3 to 15 months (mean, 8 months). All patients maintained or improved their vision; the average gain in visual acuity was three lines (range: 1-9 lines). No injection complications or drug-related side effects were noted during the follow-up period.
Intravitreal ranibizumab to treat CNV complicated by high myopia seems to be associated with an improvement in VA and good tolerance. This study confirms the efficacy of first-line anti-VEGF, in particular, ranibizumab in this indication.
In this series of eyes with limited follow-up, intravitreal ranibizumab was a safe and effective treatment for CNV secondary to PM, resulting in functional and anatomic improvement.
黄斑脉络膜新生血管(CNV)是高度近视的一种严重并发症,会影响年轻患者的视力预后。本研究的目的是评估一线玻璃体内注射雷珠单抗治疗近视性CNV的安全性和有效性。
我们于2009年1月至2010年4月在贝尼-梅苏斯大学医院对继发于病理性近视(PM)的黄斑中心凹下或中心凹旁CNV患者进行了一项单中心前瞻性、连续性、干预性研究,这些患者接受了玻璃体内注射雷珠单抗治疗。对所有患者在基线时以及每月进行最佳矫正视力(BCVA)、眼底检查、光学相干断层扫描(OCT)和荧光素血管造影(FA)。再次治疗的指征是新生血管活动持续或复发。
该研究纳入了40例患者的40只眼,其中33例为女性(82.5%),平均年龄为40.22±10.81岁(范围20 - 55岁),视力在1/100至1/10之间。平均等效球镜屈光不正为-14.13±4.65屈光度(范围-7 D至-23 D)。平均随访时间为8个月(范围3 - 15个月)。每位患者玻璃体内注射的平均次数为2.2次(范围:1 - 4次)。随访时间为3至15个月(平均8个月)。所有患者的视力均保持或提高;视力平均提高了3行(范围:1 - 9行)。随访期间未观察到注射并发症或药物相关副作用。
玻璃体内注射雷珠单抗治疗高度近视合并的CNV似乎与视力改善和良好耐受性相关。本研究证实了一线抗血管内皮生长因子药物,特别是雷珠单抗在该适应症中的疗效。
在这组随访有限的眼中,玻璃体内注射雷珠单抗是治疗PM继发CNV的一种安全有效的方法,可导致功能和解剖学改善。