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玻璃体内雷珠单抗治疗视网膜静脉阻塞所致黄斑水肿。

Intravitreal ranibizumab for macular edema secondary to retinal vein occlusion.

机构信息

Department of Ophthalmology, Inje University Seoul Paik Hospital, Seoul, Korea.

出版信息

Ophthalmologica. 2012;227(3):132-8. doi: 10.1159/000334906. Epub 2011 Dec 29.

Abstract

BACKGROUND/AIMS: To investigate the effects of intravitreal ranibizumab treatment for macular edema (ME) secondary to retinal vein occlusion (RVO) and the relationship between spectral-domain optical coherence tomography (SD-OCT) findings and visual outcome after successful resolution of ME.

METHODS

Forty consecutive eyes with ME secondary to branch RVO (BRVO; 29 eyes of 29 patients) or central RVO (CRVO; 11 eyes of 11 patients) were included in a prospective study and treated with 3 initial intravitreal injections of 0.5 mg ranibizumab at monthly intervals. Retreatment was based on visual acuity changes and OCT findings. Patients with complete resolution of ME were classified into two groups according to final best-corrected visual acuity (BCVA) of better than 0.30 logMAR (group 1) or poorer than 0.30 logMAR (group 2), and SD-OCT findings were analyzed at baseline and at 12 months.

RESULTS

In patients with BRVO, mean BCVA at 12 months (0.19 ± 0.18) was significantly better than that at baseline (0.76 ± 0.37; p = 0.000). The mean number of injections was 4.4 ± 1.2. In patients with CRVO, the mean BCVA at 12 months (0.39 ± 0.23) was slightly improved from that at baseline (0.84 ± 0.68), but the difference was not significant (p = 0.063). Patients with CRVO received a mean number of 6.1 ± 1.4 injections of ranibizumab. Baseline SD-OCT more frequently detected the foveal inner/outer segment (IS/OS) line and external limiting membrane (ELM) in group 1 (p = 0.003) than in group 2 (p = 0.012). Preservation of the foveal IS/OS line (odds ratio = 5.400; p = 0.036) and ELM (odds ratio = 7.312; p = 0.016) at baseline correlated with good final visual outcome.

CONCLUSION

Intravitreal ranibizumab injections effectively treat ME secondary to RVO. Good visual outcome was associated with preservation of the foveal IS/OS line and ELM at baseline.

摘要

背景/目的:研究玻璃体内雷珠单抗(ranibizumab)治疗视网膜静脉阻塞(RVO)继发黄斑水肿(ME)的效果,以及 ME 成功消退后,频域光学相干断层扫描(SD-OCT)结果与视力预后的关系。

方法

40 例 RVO 继发 ME 患者(29 例患者 29 只眼为分支 RVO[BRVO],11 例患者 11 只眼为中央 RVO[CRVO])纳入一项前瞻性研究,均接受 3 次每月 1 次的玻璃体内 0.5mg 雷珠单抗初始治疗。根据视力变化和 OCT 结果进行再治疗。根据最终最佳矫正视力(BCVA)是否优于 0.30 logMAR(好于 0.30 组,组 1)或差于 0.30 logMAR(差于 0.30 组,组 2)将 ME 完全消退的患者分为两组,分析基线和 12 个月时的 SD-OCT 结果。

结果

BRVO 患者治疗后 12 个月时平均 BCVA(0.19 ± 0.18)显著优于基线时(0.76 ± 0.37;p = 0.000)。平均注射次数为 4.4 ± 1.2。CRVO 患者治疗后 12 个月平均 BCVA(0.39 ± 0.23)略高于基线时(0.84 ± 0.68),但差异无统计学意义(p = 0.063)。CRVO 患者平均接受 6.1 ± 1.4 次雷珠单抗注射。与组 2 相比,组 1 患者基线时 SD-OCT 更常检测到中心凹内/外界膜(IS/OS)线和外界膜(ELM)(p = 0.003)。与良好的最终视力结果相关的是基线时保留中心凹 IS/OS 线(比值比=5.400;p = 0.036)和 ELM(比值比=7.312;p = 0.016)。

结论

玻璃体内雷珠单抗注射可有效治疗 RVO 继发 ME。良好的视力结果与基线时中心凹 IS/OS 线和 ELM 的保留有关。

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