雷珠单抗玻璃体腔内注射治疗渗出性年龄相关性黄斑变性的疗效：12 个月的结果。

BACKGROUND

The aim of this paper was to evaluate functional and anatomical results of intravitreal ranibizumab injections and the course of exudative age-related macular degeneration (AMD) treatment over a 12-month observation period.

MATERIAL/METHODS: In 25 patients with active dominantly classic exudative AMD, treatment was performed according to the following schedule: 3 intravitreal injections of 0.5 mg ranibizumab at monthly intervals (saturation phase); further injections were based on activity of the neovascular process. Changes in VA and central retinal thickness (CRT) during treatment were evaluated with ANOVA testing.

RESULTS

Mean pre-treatment best corrected visual acuity was 0.73±0.27 logMAR. After the third ranibizumab injection the best results, 0.54±0.27 logMAR, were seen; 12-month results were 0.58±0.26 logMAR. Patients had a mean improvement of 10.6 letters at 12 months. In 92% of patients stabilization or improvement of vision was observed. The mean number of injections in the 12-month period was 6. Baseline mean CRT was 351.12±74.15 µm. After the first ranibizumab injection it decreased significantly to 221.96±60.85 µm, after the third injection it was 200.80±47.63 µm, and after 12 months it was 213.16±44.37 µm. Mean correlations between baseline average CRT and baseline average VA measured in ETDRS letters (p=0.017) and in logMAR scale (p=0.033) and between average CRT after the third injection and average VA in logMAR scale after the third injection (p=0.047) were noted.

CONCLUSIONS

Treatment with intravitreal ranibizumab injections according to the presented scheme provides AMD patients with a chance of stabilization and improvement of the topical state, with a lower number of injections and preserved topical and general safety. Our results suggest that regular monthly controls are necessary to be able react rapidly to the smallest signs of deterioration, not only in visual acuity, but also in OCT images.

背景

本文旨在评估玻璃体内雷珠单抗注射的功能和解剖学结果，以及在 12 个月的观察期内渗出性年龄相关性黄斑变性（AMD）的治疗过程。

材料/方法：在 25 名患有活跃的显性经典渗出性 AMD 的患者中，按照以下方案进行治疗：每月间隔 3 次玻璃体内注射 0.5 mg 雷珠单抗（饱和期）；根据新生血管过程的活动进一步注射。使用 ANOVA 检验评估治疗过程中 VA 和中心视网膜厚度（CRT）的变化。

结果

治疗前最佳矫正视力的平均对数视力值为 0.73±0.27 logMAR。第三次雷珠单抗注射后，最佳结果为 0.54±0.27 logMAR，12 个月时的结果为 0.58±0.26 logMAR。患者在 12 个月时平均提高了 10.6 个字母。92%的患者观察到视力稳定或改善。12 个月期间的平均注射次数为 6 次。基线平均 CRT 为 351.12±74.15 µm。第一次雷珠单抗注射后，它显著降低至 221.96±60.85 µm，第三次注射后为 200.80±47.63 µm，12 个月后为 213.16±44.37 µm。在 ETDRS 字母中，基线平均 CRT 与基线平均 VA 之间（p=0.017）和对数 MAR 尺度之间（p=0.033）以及第三次注射后平均 CRT 与第三次注射后平均 VA 之间（p=0.047）之间存在显著相关性。