Qureshi Farhan, Saeed M U, Kamal A
Aintree University Hospital, Longmoor Lane, Liverpool.
Semin Ophthalmol. 2011 Mar;26(2):52-4. doi: 10.3109/08820538.2011.559515.
Myopic chorodial neovascularisation (mCNV) is an important cause of visual loss in high myopia with almost 10% of eyes with pathological myopia developing mCNV. Intravitreal anti-VEGF agents have recently been documented to be effective in mCNV. However, controversy exists regarding the optimal drug, its dose, and the frequency of administration. We performed a retrospective case review examining patients who had myopia of less than -6D and a chorodial neovascular membrane diagnosed on fundus fluorescein angiography (FFA) that were treated with 3 injections of ranibizumab (Lucentis) 5mg/0.05ml given at monthly intervals. The course was repeated if the ocular coherence tomography (OCT) continued to show intra-retinal oedema at review. We recorded logMAR visual acuities and central foveal thickness (CFT) at baseline and final review. Improvement in visual acuity was significantly improved (p = 0.049) by a mean of 0.24 logMAR (range 0 to 0.74). Every patient achieved at least visual stability. Mean CFT reduction was also significantly improved (p = 0.02) by a mean of 109 microns (range -8 to 198). Our series and current literature seem to support as primary treatment a standard dose of an anti-VEGF agent. Further, larger studies are required to clarify whether any particular injection strategy is clearly superior.
近视性脉络膜新生血管形成（mCNV）是高度近视患者视力丧失的重要原因，近10%的病理性近视患者会发生mCNV。玻璃体内注射抗血管内皮生长因子（VEGF）药物最近已被证明对mCNV有效。然而，关于最佳药物、剂量和给药频率仍存在争议。我们进行了一项回顾性病例研究，检查那些近视度数低于-6D且经眼底荧光血管造影（FFA）诊断为脉络膜新生血管膜的患者，这些患者接受了每月一次的3次雷珠单抗（Lucentis）5mg/0.05ml注射治疗。如果在复查时光学相干断层扫描（OCT）仍显示视网膜内水肿，则重复该疗程。我们记录了基线和最终复查时的对数最小分辨角视力（logMAR）和中心凹厚度（CFT）。视力改善显著（p = 0.049），平均提高了0.24 logMAR（范围为0至0.74）。每位患者至少实现了视力稳定。平均CFT降低也显著改善（p = 0.02），平均降低了109微米（范围为-8至198）。我们的系列研究和当前文献似乎支持将标准剂量的抗VEGF药物作为主要治疗方法。此外，需要进一步开展更大规模的研究来明确是否有任何特定的注射策略明显更具优势。
