Ophthalmology Department, Hospital Clinico San Carlos, Madrid, Spain.
Am J Ophthalmol. 2011 Mar;151(3):529-34. doi: 10.1016/j.ajo.2010.09.021. Epub 2011 Jan 13.
To identify predictive factors for visual outcome and need for retreatment after treating myopic choroidal neovascularization (CNV) with ranibizumab.
A prospective interventional case series.
Sixty-seven eyes of 67 patients with myopic CNV were treated with 3 intravitreal ranibizumab injections given monthly. Best-corrected visual acuity (BCVA) and optical coherence tomography-determined central macular thickness (CMT) were recorded monthly during follow-up. Fluorescein angiography changes and the number of injections needed were also assessed.
Mean follow-up was 15.9 months. Mean BCVA improved by 7.8 letters after the first injection, 12.5 letters after 3 injections, and 12 letters by end follow-up. In 53 eyes (79.1%), BCVA improved; 40.3% gained more than 15 letters. No differences were detected in visual outcome between treatment-naïve and previously treated patients. Myopic CNV area and greatest linear dimension had diminished at the study end. The mean reduction in CMT was 93.6 μm. The mean number of injections given was 4.2. A total of 53.7% of eyes received only 3 injections. Through regression analysis, baseline BCVA (P = .006) and myopic CNV location (P = .026) were significantly correlated with BCVA at the end of follow-up. Myopic CNV location (P = .023) and prior treatment (P = .047) were significantly linked to the number of injections given. No major complications arose.
An initial treatment regimen of 3 monthly ranibizumab injections seems effective and safe to treat myopic CNV. Baseline BCVA and myopic CNV location emerged as predictive factors for visual outcome. A need for retreatment was associated with myopic CNV location and prior treatment.
确定雷珠单抗治疗近视性脉络膜新生血管（CNV）后视力结果和再治疗需求的预测因素。
前瞻性干预性病例系列研究。
对 67 例 67 只眼近视性 CNV 患者，每月进行 3 次玻璃体内雷珠单抗注射治疗。在随访期间，每月记录最佳矫正视力（BCVA）和光学相干断层扫描（OCT）测量的中心黄斑厚度（CMT）。还评估了荧光素血管造影（FA）变化和所需的注射次数。
平均随访时间为 15.9 个月。第一次注射后平均 BCVA 提高了 7.8 个字母，第三次注射后提高了 12.5 个字母，最终随访时提高了 12 个字母。在 53 只眼（79.1%）中，BCVA 改善；40.3%的患者提高了 15 个字母以上。治疗初治患者和既往治疗患者的视力结果无差异。在研究结束时，近视性 CNV 面积和最大线性尺寸均减小。CMT 的平均减少量为 93.6μm。平均注射次数为 4.2 次。共有 53.7%的眼仅接受 3 次注射。通过回归分析，基线 BCVA（P=.006）和近视性 CNV 位置（P=.026）与随访结束时的 BCVA 显著相关。近视性 CNV 位置（P=.023）和既往治疗（P=.047）与注射次数显著相关。未发生主要并发症。
3 次每月雷珠单抗注射的初始治疗方案似乎对治疗近视性 CNV 有效且安全。基线 BCVA 和近视性 CNV 位置是视力结果的预测因素。再治疗的需要与近视性 CNV 位置和既往治疗有关。
