Parravano Mariacristina, Ricci Federico, Oddone Francesco, Missiroli Filippo, De Felici Cecilia, Varano Monica
*Fondazione G. B. Bietti-IRCCS, Rome, Italy; and †Department of Ophthalmology, University of Rome Tor Vergata, Rome, Italy.
Retina. 2014 Oct;34(10):2053-62. doi: 10.1097/IAE.0000000000000201.
To assess and compare the long-term functional and anatomical outcomes in eyes with myopic choroidal neovascularization (CNV) treated with intravitreal injections of ranibizumab or with photodynamic therapy (PDT).
Eighty-five eyes of 85 consecutive patients with myopic CNV and treated with either PDT (43/85) or ranibizumab 0.5 mg (42/85) and at least 24 months of follow-up were collected. Data from the best-corrected visual acuity, optical coherence tomography, and fluorescein angiography were compared between the groups. Differences in the regression pattern of myopic CNV and the rate of chorioretinal atrophy development were also compared between the groups.
The effect of treatment over time on best-corrected visual acuity and the central retinal thickness was significantly greater in the ranibizumab group (P = 0.0012 and P < 0.0002, respectively), with eyes treated with ranibizumab showing a significant central retinal thickness decrease since the first visit and maintained until 24 months. The proportion of patients showing a complete closure of CNV was similar between the groups (93% [39 of 42 eyes in the ranibizumab group] vs. 88% [38 of 43 eyes in the PDT group], P = 0.48). Both treatments were associated with an increase of chorioretinal atrophy size, which was greater in the PDT-treated eyes (P = 0.016).
Ranibizumab therapy showed a greater long-term efficacy compared with PDT in myopic CNV eyes, with a fewer proportion of eyes developing an increase of lesion and chorioretinal atrophy size.
评估并比较玻璃体内注射雷珠单抗或光动力疗法（PDT）治疗近视性脉络膜新生血管（CNV）眼的长期功能和解剖学结果。
收集85例连续的近视性CNV患者的85只眼，这些患者接受了PDT（43/85）或0.5mg雷珠单抗治疗（42/85），并进行了至少24个月的随访。比较两组之间最佳矫正视力、光学相干断层扫描和荧光素血管造影的数据。还比较了两组近视性CNV消退模式和脉络膜视网膜萎缩发展率的差异。
雷珠单抗组治疗随时间对最佳矫正视力和中心视网膜厚度的影响显著更大（分别为P = 0.0012和P < 0.0002），接受雷珠单抗治疗的眼睛自首次就诊以来中心视网膜厚度显著降低，并维持至24个月。两组中显示CNV完全闭合的患者比例相似（雷珠单抗组42眼中的39眼，93%；PDT组43眼中的38眼，88%，P = 0.48）。两种治疗均与脉络膜视网膜萎缩面积增加有关，PDT治疗的眼睛中萎缩面积增加更大（P = 0.016）。
在近视性CNV眼中，与PDT相比，雷珠单抗治疗显示出更大的长期疗效，发生病变增加和脉络膜视网膜萎缩面积增加的眼比例更低。
