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预测眼内注射雷珠单抗治疗息肉状脉络膜血管病变后视网膜液吸收的因素。

Predictive factors of resolved retinal fluid after intravitreal ranibizumab for polypoidal choroidal vasculopathy.

机构信息

Department of Ophthalmology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-0841, Japan.

出版信息

Br J Ophthalmol. 2011 Nov;95(11):1555-9. doi: 10.1136/bjophthalmol-2011-300285. Epub 2011 Sep 2.

Abstract

BACKGROUND/AIMS: To investigate the predictive factors for the resolution of retinal fluid after intravitreal injections of ranibizumab (IVRs) for polypoidal choroidal vasculopathy (PCV).

METHODS

Forty-seven eyes of 45 patients with symptomatic PCV received 0.5 mg of IVR monthly for 3 months. One month after the third IVR, the presence of dry macula, defined as absence of retinal fluid as detected by the use of optical coherence tomography, was retrospectively evaluated and correlated with clinical characteristics at baseline. Most of the eyes were followed for over 6 months.

RESULTS

Of the 47 eyes, 31 eyes (66%) achieved the dry macula along with increased best-corrected visual acuity (BCVA) (0.64 to 0.46 logarithm of the minimum angle of resolution units, p<0.0001), while the other 16 eyes without dry macula showed no significant change of BCVA. Univariate analyses of the baseline characteristics identified the smaller size of the largest polyp (p=0.0008) and the absence of serous or haemorrhagic pigment epithelial detachment (p=0.045) as predictive factors for the dry macula. Multivariate logistic regression found the independent predictor for the dry macula to be the smaller size of the largest polyp (p=0.001). No severe systemic or ocular adverse events were observed.

CONCLUSIONS

IVR may be helpful for resolution of retinal fluid and increased BCVA in the short term, but larger polyps and pigment epithelial detachments at baseline may be negative prognostic factors for a therapeutic response. Further studies are needed to clarify the long-term efficacy of IVR for PCV.

摘要

背景/目的:研究玻璃体内注射雷珠单抗(IVR)治疗息肉状脉络膜血管病变(PCV)后视网膜积液消退的预测因素。

方法

45 例有症状的 PCV 患者的 47 只眼每月接受 0.5mg 的 IVR 治疗,共 3 个月。在第三次 IVR 后 1 个月,回顾性评估干性黄斑的存在情况,定义为光学相干断层扫描(OCT)检测到无视网膜积液,并将其与基线时的临床特征相关联。大多数患者随访时间超过 6 个月。

结果

在 47 只眼中,31 只眼(66%)达到干性黄斑,同时最佳矫正视力(BCVA)提高(0.64 至 0.46 最小角分辨率对数单位,p<0.0001),而另外 16 只眼没有干性黄斑,BCVA 无明显变化。对基线特征的单因素分析发现,最大息肉的较小尺寸(p=0.0008)和无浆液性或出血性色素上皮脱离(p=0.045)是干性黄斑的预测因素。多变量逻辑回归发现,最大息肉较小是干性黄斑的独立预测因素(p=0.001)。未观察到严重的全身或眼部不良事件。

结论

IVR 可能有助于短期内消退视网膜积液和提高 BCVA,但基线时较大的息肉和色素上皮脱离可能是治疗反应的负面预后因素。需要进一步的研究来阐明 IVR 治疗 PCV 的长期疗效。

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