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初治特发性脉络膜新生血管的抗血管内皮生长因子治疗:一项比较研究。

ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY FOR NAIVE IDIOPATHIC CHOROIDAL NEOVASCULARIZATION: A Comparative Study.

作者信息

Sudhalkar Aditya, Yogi Rohit, Chhablani Jay

机构信息

*Eye Hospital and Retina Centre, Baroda, India; and †Smt. Kanuri Santhamma Centre for Vitreoretinal Diseases, LV Prasad Eye Institute, Hyderabad, India.

出版信息

Retina. 2015 Jul;35(7):1368-74. doi: 10.1097/IAE.0000000000000491.

Abstract

PURPOSE

To determine the clinical characteristics of patients with idiopathic choroidal neovascularization and to compare outcomes between intravitreal bevacizumab (IVB) and ranibizumab as therapy.

METHODS

Retrospective analysis included demographics, the corrected distance visual acuity, details of the ocular examination, imaging, treatment, outcomes, and adverse events. Patients with minimum of 1-year follow-up were included in the study. Primary outcome measure was change in corrected distance visual acuity at the final visit compared with baseline. Secondary outcome measures were change in central macular thickness and subretinal fluid (if present) with treatment and adverse events.

RESULTS

This study included 47 eyes of 45 patients with 30 males. Intravitreal bevacizumab group included 29 eyes (27 patients; with a median age of 39.4 ± 7.3 years). Intravitreal ranibizumab group included 18 eyes (18 patients; median age: 36.8 ± 9.3 years). Median baseline corrected distance visual acuity (logMAR) improved from 0.59 ± 0.38 to 0.2 ± 0.18 (P = 0.03) in intravitreal ranibizumab group and from 0.62 ± 0.41 to 0.18 ± 0.15 logMAR (P = 0.023) in intravitreal bevacizumab group. Median central macular thickness (in micrometers) improved from 315.11 ± 75.24 to 228.24 ± 67 (P = 0.036) in intravitreal bevacizumab group and from 327.24 ± 61.56 to 208 ± 53.42 (P = 0.031) in intravitreal ranibizumab group. There was no significant difference between groups in final corrected distance visual acuity (P = 0.31) or central macular thickness (P = 0.51). No adverse events were noted.

CONCLUSION

Both intravitreal ranibizumab and intravitreal bevacizumab seem equally effective in treating idiopathic choroidal neovascularization with a good safety profile without recurrence.

摘要

目的

确定特发性脉络膜新生血管患者的临床特征,并比较玻璃体内注射贝伐单抗(IVB)和雷珠单抗作为治疗方法的疗效。

方法

回顾性分析包括人口统计学资料、矫正远视力、眼部检查细节、影像学检查、治疗、疗效及不良事件。研究纳入至少随访1年的患者。主要观察指标是末次随访时矫正远视力相对于基线的变化。次要观察指标是治疗后中心黄斑厚度和视网膜下液(如有)的变化以及不良事件。

结果

本研究纳入45例患者的47只眼,其中男性30例。玻璃体内注射贝伐单抗组包括29只眼(27例患者;中位年龄39.4±7.3岁)。玻璃体内注射雷珠单抗组包括18只眼(18例患者;中位年龄:36.8±9.3岁)。玻璃体内注射雷珠单抗组的中位基线矫正远视力(logMAR)从0.59±0.38提高到0.2±0.18(P = 0.03),玻璃体内注射贝伐单抗组从0.62±0.41提高到0.18±0.15 logMAR(P = 0.023)。玻璃体内注射贝伐单抗组的中位中心黄斑厚度(单位:微米)从315.11±75.24降至228.24±67(P = 0.036),玻璃体内注射雷珠单抗组从327.24±61.56降至208±53.42(P = 0.031)。两组间末次矫正远视力(P = 0.31)或中心黄斑厚度(P = 0.51)无显著差异。未观察到不良事件。

结论

玻璃体内注射雷珠单抗和玻璃体内注射贝伐单抗在治疗特发性脉络膜新生血管方面似乎同样有效,安全性良好且无复发。

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