The Department of Ophthalmology and Visual Neuroscience, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan.
Graefes Arch Clin Exp Ophthalmol. 2011 Oct;249(10):1449-58. doi: 10.1007/s00417-011-1672-2. Epub 2011 Apr 15.
The aim of this study is to evaluate the early visual impacts of various optical coherence tomographic (OCT) parameters after the first versus repeated intravitreal ranibizumab injection in patients with exudative age-related macular degeneration (AMD).
A retrospective comparative case series study was conducted on 20 eyes of 18 consecutive patients who received intravitreal ranibizumab injection for exudative AMD either for the first time (group 1; n = 8) with no prior anti-vascular endothelial growth factor (anti-VEGF) injection in the same or fellow eye, or for repeated times during the course of monthly injected ranibizumab (group 2; n = 12 eyes). The following baseline and 1 month post-injection data was collected for both groups and compared: best-corrected visual acuity (BCVA), qualitative and quantitative OCT parameters including: foveal thickness, foveal volume (central 1-mm circle), retinal volume at 3- and 5-mm central circles, retinal pigment epithelium (RPE) elevation, type of fluid collections, and type of AMD lesion. The size of the fluid and fibrovascular lesion (FVL) areas were measured using manual delineation and automatic calculation of the device. We made correlations between the post-injection visual acuity (VA) and each of post-injection OCT parameters in both groups and these were the main outcome measures.
In group 1, there was a strong correlation between post-injection logarithm of minimum angle of resolution (logMAR) BCVA and each of the following: FVL size, foveal thickness, retinal volume at 3- and 5-mm central circles, RPE elevation, the size of the fluid area, and age of the patient (r > 0.70, p < 0.05), whereas in group 2; logMAR BCVA was strongly correlated only with foveal volume (r = 0.74, p = 0.01). Multivariate analysis showed that post-injection FVL size (r (2) = 0.69) and foveal volume (r (2) = 0.55) were the most important factors for VA 1 month following the initial and repeated ranibizumab injection, respectively.
The size of FVL and foveal volume showed a significant correlation with VA in AMD patients shortly after the first and repeated ranibizumab injection, respectively. Further studies with larger sample sizes are needed in order to support these results.
本研究旨在评估初次与重复玻璃体内雷珠单抗注射后，各种光学相干断层扫描（OCT）参数对年龄相关性黄斑变性（AMD）患者早期视力的影响。
对 18 例（20 只眼）接受玻璃体内雷珠单抗注射治疗渗出性 AMD 的患者进行回顾性对比病例系列研究。患者要么是初次（第 1 组；n=8 只眼），要么是在同一眼或对侧眼接受过无抗血管内皮生长因子（抗-VEGF）治疗（第 2 组；n=12 只眼）。比较两组患者的基线和注射后 1 个月的以下数据：最佳矫正视力（BCVA）、定性和定量 OCT 参数，包括：中心凹厚度、中心 1mm 圆的中心凹体积、3mm 和 5mm 中央环的视网膜体积、视网膜色素上皮（RPE）隆起、液体积聚类型和 AMD 病变类型。使用手动描绘和设备自动计算测量液体积聚和纤维血管性病变（FVL）区域的大小。我们比较了两组患者注射后视力（VA）与 OCT 各参数之间的相关性，这些是主要的观察指标。
第 1 组中，注射后最小分辨角对数视力（logMAR）BCVA 与 FVL 大小、中心凹厚度、3mm 和 5mm 中央环的视网膜体积、RPE 隆起、液体积聚面积和患者年龄之间存在强相关性（r>0.70，p<0.05），而第 2 组中，logMAR BCVA 仅与中心凹体积有强相关性（r=0.74，p=0.01）。多变量分析显示，初次和重复玻璃体内雷珠单抗注射后 1 个月的 VA 主要与注射后 FVL 大小（r²=0.69）和中心凹体积（r²=0.55）相关。需要进一步进行更大样本量的研究以支持这些结果。
