Laser and Retinal Research Unit, King's College Hospital, University of London, London, UK.
Eye (Lond). 2011 Feb;25(2):149-53. doi: 10.1038/eye.2010.167. Epub 2010 Nov 19.
To compare fixation location and stability in patients with neovascular age-related macular degeneration (AMD) treated with or without ranibizumab.
Patients were recruited from the Macular Clinic of the King's College Hospital in London. Two groups of patients with neovascular AMD with at least 12 months of follow-up were included in the study. The treated group was treated with ranibizumab while the untreated group did not have any treatment. Best corrected visual acuity (BCVA) with modified ETDRS chart, fixation location and stability as measured with Nidek MP1, central retinal thickness as measured by Zeiss Cirrus SD-optical coherent tomography (OCT), and lesion size as measured by Topcon TRC-50IX camera were analysed and correlated.
In total, 102 eyes were included in the study with 76 in the ranibizumab-treated group and 26 in the untreated group. There were no significantly demographic differences between the two groups. However, as expected, the treated group has significantly better vision (48.5 vs 15.5 letters, P < 0.0001) and smaller lesions (10.8 vs 18.3 mm(2), P = 0.004), the central macular thickness as measured by OCT also showed a trend of normalised macular thickness (252 vs 282 microns, P = 0.07). The location of fixation was significantly more central in the ranibizumab-treated group (χ(2) 17.9, P < 0.0001) with over 50% of eyes with predominantly central fixation. Majority (84.6%) of the patients in the untreated group had predominantly eccentric fixation. Fixation stability was significantly better in the ranibizumab-treated group as compared with the untreated group, using both the software provided by the MP1 machine (χ(2) 21.8, P < 0.0001) and the mean log bivariate contour ellipse area calculated from the raw data obtained from the machine (3.64 vs 4.39 in treated and untreated group respectively, P < 0.0001).
Low vision rehabilitation strategy for this group of patients in the ranibizumab era will be very different from those used in untreated patients with dense central scotoma. Further studies on the visual rehabilitation in the ranibizumab-treated patients should consider fixation characteristics of the patients.
比较接受或未接受雷珠单抗治疗的新生血管性年龄相关性黄斑变性（AMD）患者的固视位置和稳定性。
从伦敦国王学院医院的黄斑诊所招募患者。研究纳入了两组至少有 12 个月随访的新生血管性 AMD 患者。治疗组接受雷珠单抗治疗，未治疗组则未进行任何治疗。使用改良 ETDRS 图表评估最佳矫正视力（BCVA）、使用 Nidek MP1 测量固视位置和稳定性、使用 Zeiss Cirrus SD-光学相干断层扫描（OCT）测量中心视网膜厚度，使用 Topcon TRC-50IX 相机测量病变大小，并进行分析和相关性研究。
本研究共纳入 102 只眼，其中 76 只眼接受雷珠单抗治疗，26 只眼未治疗。两组患者的人口统计学差异无统计学意义。然而，如预期的那样，治疗组的视力明显更好（48.5 个字母 vs 15.5 个字母，P < 0.0001），病变更小（10.8mm² vs 18.3mm²，P = 0.004），OCT 测量的黄斑中心厚度也显示出黄斑厚度正常化的趋势（252μm vs 282μm，P = 0.07）。雷珠单抗治疗组的固视位置明显更靠近中心（χ² 17.9，P < 0.0001），超过 50%的患者以中央固视为主。未治疗组的大多数（84.6%）患者以偏心固视为主。与未治疗组相比，雷珠单抗治疗组的固视稳定性明显更好，使用 MP1 机器提供的软件（χ² 21.8，P < 0.0001）和从机器原始数据计算得出的平均双变量轮廓椭圆面积（治疗组和未治疗组分别为 3.64 和 4.39，P < 0.0001）。
在雷珠单抗时代，这组患者的低视力康复策略将与未治疗的密集中心暗点患者有很大不同。对雷珠单抗治疗患者的视觉康复的进一步研究应考虑患者的固视特征。
