Holm Kristina, Schroeder Marion, Lövestam Adrian Monica
Department of Ophthalmology, University of Lund, 221 85, Lund, Sweden,
Doc Ophthalmol. 2015 Aug;131(1):43-51. doi: 10.1007/s10633-015-9495-9. Epub 2015 Mar 15.
To evaluate the influence of ranibizumab on the multifocal electroretinogram (Mf-ERG), full-field electroretinogram (Ff-ERG) and optical coherence tomography (OCT) in diabetic eyes (n = 20) with macular oedema.
In 20 eyes (20 diabetic subjects) with no or background diabetic retinopathy and macular oedema (age 65.7 ± 9.8 years, duration 16.5 ± 10.0 years), the change in ETDRS letters, Mf-ERG, Ff-ERG and OCT was analysed, at baseline, 4 weeks after the first injection, (just before the second injection), and 4 weeks after the last injection with ranibizumab.
From baseline, mean BCVA improved from 64.0 ± 10.0 ETDRS letters to 75.0 ± 7.3 ETDRS letters (p = 0.005) 1 month after the last injection. Mean OCT thickness reduced after the first injection from 418 ± 117 to 311 ± 126 µm; (p = 0.001) and to 302 ± 74 µm after the third injection. Mf-ERG demonstrated in the innermost three rings a shorter implicit time after the first injection with p values of 0.002, 0.005 and 0.017, respectively. After the third injection, implicit time was prolonged to almost the original levels. Cone implicit time with 30-Hz flicker improved significantly between baseline (35.5 ± 3.6 ms) and final follow-up (34.6 ± 3.1 ms) (p = 0.04).
Though the central retinal thickness was reduced after three injections of ranibizumab and the subjects gained a mean of 11 ETDRS letters, there was no significant change in amplitude or implicit time in Mf-ERG. The shortened 30-Hz flicker implicit time might imply that ranibizumab has no negative impact on the entire peripheral cone function, but can improve it instead.
评估雷珠单抗对患有黄斑水肿的糖尿病眼(n = 20)的多焦视网膜电图(Mf-ERG)、全视野视网膜电图(Ff-ERG)和光学相干断层扫描(OCT)的影响。
对20只眼(20名糖尿病患者)进行研究,这些患者无糖尿病视网膜病变或仅有背景性糖尿病视网膜病变且伴有黄斑水肿(年龄65.7±9.8岁,病程16.5±10.0年),分析在基线、首次注射后4周(恰好在第二次注射前)以及最后一次注射雷珠单抗后4周时ETDRS视力表字母变化、Mf-ERG、Ff-ERG和OCT的变化。
与基线相比,末次注射后1个月,平均最佳矫正视力(BCVA)从64.0±10.0个ETDRS字母提高到75.0±7.3个ETDRS字母(p = 0.005)。首次注射后平均OCT厚度从418±117μm降至311±126μm;(p = 0.001),第三次注射后降至302±74μm。Mf-ERG显示在最内侧的三环中,首次注射后隐时缩短,p值分别为0.002、0.005和0.017。第三次注射后,隐时延长至几乎原始水平。30Hz闪烁光刺激下的视锥细胞隐时在基线(35.5±3.6ms)和最终随访时(34.6±3.1ms)之间有显著改善(p = 0.04)。
虽然三次注射雷珠单抗后中央视网膜厚度降低,患者平均获得了11个ETDRS字母,但Mf-ERG的振幅或隐时没有显著变化。30Hz闪烁光刺激下隐时缩短可能意味着雷珠单抗对整个周边视锥细胞功能没有负面影响,反而可以改善其功能。