Farinha Cláudia, Marques João Pedro, Almeida Elisabete, Baltar Alda, Santos Ana Rita, Melo Pedro, Costa Miguel, Figueira João, Cachulo Maria Luz, Pires Isabel, Silva Rufino
Medical Retina Unit, Department of Ophthalmology, Centro Hospitalar e Universitx00E1;rio de Coimbra (CHUC), Coimbra, Portugal.
Ophthalmic Res. 2015;55(1):10-8. doi: 10.1159/000440848. Epub 2015 Nov 6.
To evaluate long-term results and predictors of efficacy in patients with macular edema due to retinal vein occlusion (RVO) treated with intravitreal ranibizumab in a clinical practice setting.
The clinical records of patients with a minimum follow-up of 3 years were retrospectively analyzed. Sixteen eyes with branch RVO (BRVO) and 16 with central RVO (CRVO) were included. All patients performed cross-sectional evaluation with best-corrected visual acuity (BCVA), spectral domain optical coherence tomography and fluorescein angiography. The foveal avascular zone (FAZ) was assessed and microstructural morphology of the retina was characterized.
Follow- up was 42.9 ± 9.0 and 44.8 ± 8.0 months in the CRVO and BRVO groups, respectively. Patients with CRVO received on average 6.9 injections, with a final VA gain of 8.3 ± 15.0 letters (p = 0.05). BRVO eyes had on average 5.9 injections, with a final VA gain of 1.6 ± 21.0 letters (p > 0.05). The FAZ area remained stable in both groups (p > 0.05). Baseline BCVA and disruption of the retinal pigment epithelium (RPE) were predictors of final BCVA (p = 0.001 and 0.011, respectively).
Although functional outcomes were inferior to those reported in clinical trials, ranibizumab was satisfactory in the long-term treatment of macular edema secondary to RVO and was not associated with increased macular ischemia. Final BCVA depends on baseline BCVA and RPE integrity.
在临床实践环境中，评估玻璃体内注射雷珠单抗治疗视网膜静脉阻塞（RVO）所致黄斑水肿患者的长期疗效及疗效预测因素。
对随访时间至少3年的患者临床记录进行回顾性分析。纳入16只分支视网膜静脉阻塞（BRVO）眼和16只中心视网膜静脉阻塞（CRVO）眼。所有患者均采用最佳矫正视力（BCVA）、频域光学相干断层扫描和荧光素血管造影进行横断面评估。评估黄斑无血管区（FAZ）并对视网膜的微观结构形态进行特征描述。
CRVO组和BRVO组的随访时间分别为42.9±9.0个月和44.8±8.0个月。CRVO患者平均接受6.9次注射，最终视力提高8.3±15.0个字母（p = 0.05）。BRVO眼平均接受5.9次注射；最终视力提高1.6±21.0个字母（p>0.05）。两组的FAZ面积均保持稳定（p>0.05）。基线BCVA和视网膜色素上皮（RPE）破坏是最终BCVA的预测因素（分别为p = 0.001和0.011）。
尽管功能结果不如临床试验报道的那样好，但雷珠单抗在RVO继发黄斑水肿的长期治疗中效果令人满意，且与黄斑缺血增加无关。最终BCVA取决于基线BCVA和RPE完整性。
