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日本患者息肉状脉络膜血管病变接受每月三次雷珠单抗注射和按需再注射的一年结果。

One-year results of three monthly ranibizumab injections and as-needed reinjections for polypoidal choroidal vasculopathy in Japanese patients.

机构信息

Ohtsuka Eye Hospital, Sapporo, Japan.

出版信息

Am J Ophthalmol. 2012 Jul;154(1):117-124.e1. doi: 10.1016/j.ajo.2011.12.019. Epub 2012 Apr 1.

Abstract

PURPOSE

To investigate the 1-year outcomes of monthly intravitreal injections of ranibizumab for 3 months followed by an as-needed reinjection schedule to treat polypoidal choroidal vasculopathy (PCV) in Japanese patients.

DESIGN

Prospective, consecutive case series.

METHODS

Eighty-five eyes of 82 consecutive Japanese patients with naïve symptomatic PCV received monthly intravitreal injections of ranibizumab for 3 months followed by an as-needed reinjection schedule. Eighty-one eyes (95%) followed for 1 year were studied.

RESULTS

A mean of 4.2 ± 1.3 (mean ± standard deviation) injections were administered over 1 year. Twenty-three of 81 eyes (28%) did not require additional injections and 32 eyes (40%) required only 1 injection after the 3 monthly injections. The mean (± standard error) logarithm of minimal angle of resolution (logMAR) visual acuity (VA) at baseline was 0.59 ± 0.37 and improved to 0.37 ± 0.30 (P = .001). Thirty eyes (37%) and 5 eyes (6%), respectively, had improved and decreased VA of 0.3 or more logMAR unit. Indocyanine green angiography showed that the polypoidal lesions resolved in 21 eyes (26%) and 32 eyes (40%) 3 months and 1 year after the first injection, respectively. Abnormal choroidal vessels remained in all eyes.

CONCLUSIONS

Monthly injections of ranibizumab for 3 months to treat PCV improved the VA, and a reinjection schedule based on need maintained the improved VA. The polypoidal lesions tended to improve over 1 year, whereas abnormal choroidal vessels remained in all eyes. Further long-term follow-up is needed to determine the efficacy of ranibizumab therapy for PCV.

摘要

目的

研究每月玻璃体内注射雷珠单抗治疗 3 个月后按需进行再注射方案,以治疗日本患者息肉样脉络膜血管病变(PCV)的 1 年疗效。

设计

前瞻性、连续病例系列。

方法

82 例初治有症状 PCV 的日本患者 85 只眼接受每月玻璃体内注射雷珠单抗治疗 3 个月,随后按需进行再注射方案。81 只眼(95%)随访 1 年。

结果

1 年平均注射 4.2 ± 1.3(平均值 ± 标准差)次。81 只眼中 23 只眼(28%)无需额外注射,32 只眼(40%)在 3 次每月注射后仅需 1 次注射。基线时最小分辨角对数视力(logMAR)的平均(±标准误差)值为 0.59 ± 0.37,改善至 0.37 ± 0.30(P =.001)。30 只眼(37%)和 5 只眼(6%)的视力分别提高了 0.3 个或更多 logMAR 单位。吲哚青绿血管造影显示,第 1 次注射后 3 个月和 1 年时,21 只眼(26%)和 32 只眼(40%)的息肉样病变消退。所有眼均存在异常脉络膜血管。

结论

每月玻璃体内注射雷珠单抗治疗 3 个月治疗 PCV 可改善视力,根据需要进行再注射方案可维持改善的视力。息肉样病变在 1 年内趋于改善,而所有眼的异常脉络膜血管仍存在。需要进一步的长期随访来确定雷珠单抗治疗 PCV 的疗效。

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