Rishi Pukhraj, Kasinathan Nachiappan, Sahu Chinmaya
Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, 18 College Road, Chennai-600006. Tamil Nadu, India.
Clin Ophthalmol. 2011;5:167-70. doi: 10.2147/OPTH.S16947. Epub 2011 Feb 11.
To report the occurrence of foveal atrophy and macular hole formation following intravitreal ranibizumab with or without photodynamic therapy for choroidal neovascularization caused by age-related macular degeneration.
This was a retrospective, interventional case series, in which 78 eyes of 76 patients were treated for wet age-related macular degeneration between February 2007 and August 2007. Of these, three eyes developed foveal atrophy following treatment. Two eyes underwent combination photodynamic therapy and intravitreal ranibizumab, and one eye underwent intravitreal ranibizumab alone. One of the two eyes that underwent combination therapy progressed to develop a macular hole.
On the first follow-up visit, all three eyes showed thinning of the fovea on optical coherence tomography. Subsequently, treatment was continued with repeat intravitreal ranibizumab injections. At the last follow-up, although choroidal neovascularization regressed in all eyes, extensive foveal atrophy developed in two eyes with macular hole formation in one eye.
The possibility of foveal atrophy and macular hole formation must be borne in mind before initiating ranibizumab in combination with or without photodynamic therapy. However, larger studies with longer follow-up are required to understand such adverse effects better.
报告玻璃体内注射雷珠单抗联合或不联合光动力疗法治疗年龄相关性黄斑变性引起的脉络膜新生血管后黄斑中心凹萎缩和黄斑裂孔形成的发生情况。
这是一项回顾性干预性病例系列研究，76例患者的78只眼在2007年2月至2007年8月期间接受了湿性年龄相关性黄斑变性治疗。其中，3只眼在治疗后出现黄斑中心凹萎缩。2只眼接受了光动力疗法联合玻璃体内注射雷珠单抗，1只眼仅接受了玻璃体内注射雷珠单抗。接受联合治疗的2只眼中有1只进展为黄斑裂孔。
在首次随访时，所有3只眼在光学相干断层扫描上均显示黄斑中心凹变薄。随后，继续进行玻璃体内重复注射雷珠单抗治疗。在最后一次随访时，尽管所有眼的脉络膜新生血管均消退，但2只眼出现广泛的黄斑中心凹萎缩，其中1只眼形成黄斑裂孔。
在开始使用雷珠单抗联合或不联合光动力疗法之前，必须牢记黄斑中心凹萎缩和黄斑裂孔形成的可能性。然而，需要进行更大规模、更长随访时间的研究，以更好地了解此类不良反应。
