Department of Ophthalmology, University Hospital of Wales, Cardiff, UK.
Eye (Lond). 2011 Dec;25(12):1617-21. doi: 10.1038/eye.2011.224. Epub 2011 Sep 16.
The beneficial effect of intravitreal ranibizumab in the treatment of neovascular age-related macula degeneration (nAMD) is well known. Outcome data for eyes presenting with visual acuity better than 6/12 is limited.
To assess the effect of baseline vision on outcome in ranibizumab-treated nAMD eyes, including a subgroup with baseline vision ≥6/12 (<0.30 logmar).
Prospective, consecutive and interventional case series.
A consecutive cohort of patients treated with intravitreal ranibizumab for nAMD with 52-week follow-up were studied. Patients who had received previous treatment for nAMD were excluded. Eyes were stratified according to baseline logmar visual acuity into four groups: <0.30 (>6/12), 0.30-0.59 (6/12-6/24), 0.60-0.99 (6/24-6/60) and 1.00-1.20 (6/60-6/96). Intravitreal ranibizumab (0.5 mg in 0.05 ml) was administered in three loading monthly doses followed by PRN dosing according to optical coherence tomography (OCT) findings.
A total of 615 eyes were studied including 88 eyes with baseline vision <0.30. The mean change in logmar letters at 52 weeks was +5.5 (entire study group), -0.5 (<0.30 subgroup), +2.2 (0.30-0.59 subgroup), +6.5 (0.60-0.99 subgroup) and +15.3 (1.00-1.20 subgroup). In the <0.30 subgroup, 60 of 88 eyes (68%) had best-corrected visual acuity (BCVA) equal to or better than baseline and 82 of 88 eyes (93%) lost <15 letters at 52 weeks. Within this subgroup 56 of 67 eyes (84%) maintained UK driving standard BCVA visual acuity over the study period.
This study provides evidence that intravitreal ranibizumab treatment stabilises good vision in nAMD presenting with vision better than 6/12 over 52 weeks follow-up.
玻璃体内注射雷珠单抗治疗新生血管性年龄相关性黄斑变性（nAMD）的有益效果已广为人知。但是目前关于视力优于 6/12 的患者的治疗结果数据有限。
评估基线视力对接受雷珠单抗治疗的 nAMD 患者的治疗效果的影响，包括基线视力≥6/12（<0.30 logMAR）的亚组。
前瞻性、连续和干预性病例系列研究。
研究了接受玻璃体内雷珠单抗治疗 nAMD 且具有 52 周随访的连续患者队列。排除了接受过 nAMD 既往治疗的患者。根据基线 logMAR 视力将患者分为四组：<0.30（>6/12）、0.30-0.59（6/12-6/24）、0.60-0.99（6/24-6/60）和 1.00-1.20（6/60-6/96）。玻璃体内注射雷珠单抗（0.5 mg 于 0.05 ml），在最初的 3 个月每月给予 3 次负荷剂量，然后根据光学相干断层扫描（OCT）结果进行 PRN 给药。
共研究了 615 只眼，其中 88 只眼的基线视力<0.30。在 52 周时 logMAR 字母的平均变化为+5.5（整个研究组）、-0.5（<0.30 亚组）、+2.2（0.30-0.59 亚组）、+6.5（0.60-0.99 亚组）和+15.3（1.00-1.20 亚组）。在<0.30 亚组中，88 只眼中有 60 只（68%）最佳矫正视力（BCVA）与基线相等或更好，88 只眼中有 82 只（93%）在 52 周时损失的字母数<15。在此亚组中，67 只眼中有 56 只（84%）在研究期间保持了英国驾驶标准 BCVA 视力。
本研究表明，玻璃体内雷珠单抗治疗可在 52 周的随访中稳定 nAMD 患者的视力，这些患者的基线视力优于 6/12。
