Yamamoto Akiko, Okada Annabelle A, Sugitani Atsuhiko, Kunita Daisuke, Rii Tosho, Yokota Reiji
Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan.
Clin Ophthalmol. 2013;7:757-63. doi: 10.2147/OPTH.S42189. Epub 2013 Apr 19.
To describe outcomes of intravitreal ranibizumab using a pro re nata regimen for treatment-naive exudative age-related macular degeneration (AMD), in Japanese patients over the first 2 years.
Clinical records were retrospectively reviewed of 48 eyes of 48 patients with treatment-naive exudative AMD who underwent intravitreal ranibizumab therapy. After three monthly injections (induction), patients were examined monthly, and subsequent injections were performed as needed (pro re nata) for any residual activity, by fundus biomicroscopy and imaging studies, regardless of severity.
Twenty-nine (60%) of the patients were men, and 19 (40%) were women; the mean age was 76.1 years. Of the 48 eyes evaluated, 17 (35%) had findings consistent with polypoidal choroidal vasculopathy, and five (10%) with retinal angiomatous proliferation. A mean of 6.0 ranibizumab injections were given in the first year, 3.5 in the second year, and 9.5 over the 2-year period. The best-corrected visual acuity (logarithm of minimum angle of resolution) improved significantly, from 0.35 at baseline to 0.21 at 12 months (P < 0.01), and remained stable at 0.21 at 24 months (P < 0.01). The mean central macular thickness decreased significantly, from 355.4 μm at baseline to 237.9 μm at 12 months (P < 0.01) and 247.7 μm at 24 months (P < 0.01).
Improved visual acuity and decreased central macular thickness were observed and maintained over a 2-year period, in a Japanese population receiving 3 monthly induction injections followed by a pro re nata regimen of ranibizumab for exudative AMD.
描述初治的渗出性年龄相关性黄斑变性(AMD)日本患者在最初两年内使用按需给药方案玻璃体内注射雷珠单抗的治疗结果。
对48例初治的渗出性AMD患者的48只眼进行玻璃体内雷珠单抗治疗的临床记录进行回顾性分析。在进行3次每月一次的注射(诱导期)后,每月对患者进行检查,随后根据需要(按需给药)通过眼底生物显微镜检查和影像学研究对任何残留活性进行注射,无论严重程度如何。
29例(60%)患者为男性,19例(40%)为女性;平均年龄为76.1岁。在评估的48只眼中,17只(35%)的检查结果与息肉样脉络膜血管病变一致,5只(10%)与视网膜血管瘤样增殖一致。第一年平均注射雷珠单抗6.0次,第二年3.5次,两年期间共9.5次。最佳矫正视力(最小分辨角对数)显著提高,从基线时的0.35提高到12个月时的0.21(P<0.01),并在24个月时稳定在0.21(P<0.01)。平均中心黄斑厚度显著降低,从基线时的355.4μm降至12个月时的237.9μm(P<0.01)和24个月时的247.7μm(P<0.01)。
在接受3次每月诱导注射后采用雷珠单抗按需给药方案治疗渗出性AMD的日本人群中,观察到并在2年期间维持了视力提高和中心黄斑厚度降低。