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雷珠单抗治疗典型新生血管性年龄相关性黄斑变性和息肉状脉络膜血管病变的两年视力转归

Two-year visual outcome of ranibizumab in typical neovascular age-related macular degeneration and polypoidal choroidal vasculopathy.

作者信息

Hata Masayuki, Tsujikawa Akitaka, Miyake Masahiro, Yamashiro Kenji, Ooto Sotaro, Oishi Akio, Nakanishi Hideo, Takahashi Ayako, Yoshimura Nagahisa

机构信息

Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto, 606-8507, Japan.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2015 Feb;253(2):221-7. doi: 10.1007/s00417-014-2688-1. Epub 2014 Jun 25.

Abstract

PURPOSE

To investigate the 2-year outcomes of intravitreal injections of ranibizumab in typical neovascular age-related macular degeneration (tAMD) and polypoidal choroidal vasculopathy (PCV). Factors associated with visual outcomes are examined.

METHODS

We retrospectively reviewed medical records of 128 consecutive eyes with treatment-naïve subfoveal AMD treated with ranibizumab and followed for ≥24 months. The association between visual outcomes and single nucleotide polymorphisms (SNPs) in ARMS2 A69S and CFH I62V genes were examined.

RESULTS

Fifty-eight eyes were diagnosed with tAMD and 70 eyes with PCV. In tAMD eyes, visual acuity (VA) improved at 3 months (P = 0.020) but returned to the baseline level at 6 months. Thereafter, VA was maintained until 24 months. In PCV eyes, VA significantly improved at 3 months (P = 0.015) and persisted at 12 months (P = 0.025), but the VA improvement dissipated by 24 months. With regard to genetic associations with VA and VA change, neither VA nor VA change showed significant associations with these SNPs at all time points in tAMD. In the PCV eyes, there were significant associations between ARMS2 A69S and VA at baseline and 1 year (P = 0.017 and P = 0.025, respectively). However, VA change showed no significant difference among these genotypes in PCV.

CONCLUSIONS

Intravitreal ranibizumab significantly improved the VA initially, but this improvement did not persist at 2 years post-treatment. In PCV, ARMS2 A69S polymorphism is associated with the baseline and 12-month VA, but is not associated with the visual prognosis at 24 months.

摘要

目的

研究玻璃体内注射雷珠单抗治疗典型新生血管性年龄相关性黄斑变性(tAMD)和息肉状脉络膜血管病变(PCV)的2年疗效。研究与视力预后相关的因素。

方法

我们回顾性分析了128例初治的黄斑中心凹下AMD患者连续接受雷珠单抗治疗并随访≥24个月的病历。研究了ARMS2 A69S和CFH I62V基因单核苷酸多态性(SNP)与视力预后的相关性。

结果

58只眼诊断为tAMD,70只眼诊断为PCV。在tAMD组,视力(VA)在3个月时改善(P = 0.020),但在6个月时恢复到基线水平。此后,视力维持到24个月。在PCV组,视力在3个月时显著改善(P = 0.015),并持续到12个月(P = 0.025),但在24个月时视力改善消失。关于与视力及视力变化的基因相关性,在tAMD组的所有时间点,视力及视力变化均与这些SNP无显著相关性。在PCV组,ARMS2 A69S与基线及1年时的视力有显著相关性(分别为P = 0.017和P = 0.025)。然而,PCV组中这些基因型的视力变化无显著差异。

结论

玻璃体内注射雷珠单抗最初显著改善了视力,但这种改善在治疗后2年并未持续。在PCV组,ARMS2 A69S多态性与基线及12个月时的视力相关,但与24个月时的视力预后无关。

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