雷珠单抗治疗近视性脉络膜新生血管的长期可变结果

Long-term variable outcome of myopic choroidal neovascularization treated with ranibizumab.

作者信息

Cohen Salomon Y, Nghiem-Buffet Sylvia, Grenet Typhaine, Dubois Lise, Ayrault Sandrine, Fajnkuchen Franck, Delahaye-Mazza Corinne, Quentel Gabriel, Tadayoni Ramin

机构信息

Centre Ophtalmologique d'Imagerie et de Laser, 11 Rue Antoine Bourdelle, Paris, 75015, France,

出版信息

Jpn J Ophthalmol. 2015 Jan;59(1):36-42. doi: 10.1007/s10384-014-0363-z. Epub 2014 Nov 22.

Abstract

PURPOSE

The purpose was to evaluate the long-term efficacy of ranibizumab for the treatment of myopic choroidal neovascularization (CNV) in a clinical setting.

METHODS

This was a retrospective, monocentric, noncomparative analysis of 51 eyes of 51 patients with naïve juxtafoveal or subfoveal myopic CNV treated with intravitreal ranibizumab (IVR) on a pro re nata basis for at least 24 months. The patients' demographic data were recorded, including the best-corrected visual acuity (BCVA) measured with an ETDRS chart, location of the CNV, grade of myopic changes, central foveal thickness (CFT), and number of administered IVR. Outcome measures were to determine the changes in BCVA, identify the factors influencing the visual outcome, compare the best visual gain obtained for each treated eye with the final visual gain, and identify the cause of the relative decline in the visual acuity, when present.

RESULTS

BCVA improved from 58.7 ± 19.0 letters at baseline to 66.3 ± 16.2 letters at the final visit (P = 0.001; mean visual gain: +7.6 ± 15.6 letters). Multivariate analysis did not identify any correlation between the visual gain and age, sex, grade of myopic fundus changes, CNV location, or initial protocol. The mean IVR number was 3.5 ± 2.8 injections (range 1-12; median 3) for a mean follow-up of 39.3 ± 11.3 months (range 24-69). Twenty-one eyes experienced a relative decline in BCVA during the follow-up, which was attributable in 16 cases to myopic atrophic changes.

CONCLUSIONS

Intravitreal ranibizumab resulted in long-term efficacy in the treatment of myopic CNV. However, some eyes may present a long-term relative decline in their initial visual gain.

摘要

目的

本研究旨在评估雷珠单抗在临床环境中治疗近视性脉络膜新生血管(CNV)的长期疗效。

方法

这是一项回顾性、单中心、非对照分析,纳入51例初发性黄斑中心凹旁或黄斑中心凹下近视性CNV患者的51只眼,根据需要玻璃体腔内注射雷珠单抗(IVR)治疗至少24个月。记录患者的人口统计学数据,包括使用ETDRS视力表测量的最佳矫正视力(BCVA)、CNV的位置、近视改变的程度、中心凹厚度(CFT)以及IVR注射次数。观察指标包括确定BCVA的变化、识别影响视力结果的因素、比较每只治疗眼获得的最佳视力增益与最终视力增益,以及确定视力相对下降的原因(如有)。

结果

BCVA从基线时的58.7±19.0字母提高到末次随访时的66.3±16.2字母(P = 0.001;平均视力增益:+7.6±15.6字母)。多因素分析未发现视力增益与年龄、性别、近视眼底改变程度、CNV位置或初始治疗方案之间存在相关性。平均IVR注射次数为3.5±2.8次(范围1 - 12次;中位数3次),平均随访时间为39.3±11.3个月(范围24 - 69个月)。21只眼在随访期间BCVA出现相对下降,其中16例归因于近视性萎缩改变。

结论

玻璃体腔内注射雷珠单抗在治疗近视性CNV方面具有长期疗效。然而,部分患眼的初始视力增益可能会出现长期相对下降。

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