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玻璃体内注射雷珠单抗单药治疗视网膜血管瘤样增生的一年结果:基于疾病阶段的比较分析

One year results of intravitreal ranibizumab monotherapy for retinal angiomatous proliferation: a comparative analysis based on disease stages.

作者信息

Park Young Gun, Roh Young-Jung

机构信息

Department of Ophthalmology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, #62 Yeouido-dong, Yeongdeungpo-gu, Seoul, 150-713, Korea.

出版信息

BMC Ophthalmol. 2015 Dec 21;15:182. doi: 10.1186/s12886-015-0172-2.

Abstract

BACKGROUND

Retinal angiomatous proliferation (RAP) has been known as a variant of exudative age-related macular degeneration (AMD) with a unfavorable prognosis. To evaluate the effect of ranibizumab administered initially as three loading doses for patients with various stages of RAP.

METHODS

A retrospective chart review of 40 patients (41 eyes) with RAP was conducted. The study divided patients into three groups of Group I (8 eyes in stage I), Group II (17eyes in stage II), and Group III (16 eyes in stage III). All patients received three initial monthly intravitreal injections (0.5 mg) of ranibizumab and were monitored monthly for 12 months. Reinjection of ranibizumab after three initial monthly doses was administered on as-needed basis. The main outcome measures were the change in the mean of best-corrected Snellen visual acuity (BCVA) and central macular thickness (CMT), and the total number of injections received during the 12 months.

RESULTS

The mean change in BCVA at 12 months was-0.286,-0.165, and-0.151 (logMAR) in Group I, II, and III, respectively. CMT was also reduced by a mean of 32.72 ± 56.75, 57.45 ± 56.48 and 148.37 ± 98.59 μm. The mean number of injections in Group I was significant lower than those in Group II and III (P < 0.001, P < 0.001, and P = 0.15 for Group I versus Group II, Group I versus Group III, and Group II versus Group III, respectively).

CONCLUSIONS

The 12-month follow-up outcomes suggest that three consecutive loading doses of intravitreal ranibizumab is an effective treatment on early stage (stage I) of RAP. Patients in stage I showed a significantly lower recurrence rate than patients in later stages.

摘要

背景

视网膜血管瘤样增生(RAP)是渗出性年龄相关性黄斑变性(AMD)的一种变体,预后不佳。本研究旨在评估雷珠单抗初始给予三个负荷剂量对不同阶段RAP患者的疗效。

方法

对40例(41只眼)RAP患者进行回顾性病历分析。研究将患者分为三组:I组(I期8只眼)、II组(II期17只眼)和III组(III期16只眼)。所有患者均接受每月一次、连续三个月的玻璃体内注射雷珠单抗(0.5mg),并在12个月内每月进行监测。初始三个月每月一次剂量后,根据需要再次注射雷珠单抗。主要观察指标为最佳矫正视力(BCVA)平均值和中心黄斑厚度(CMT)的变化,以及12个月内接受注射的总数。

结果

I组、II组和III组在12个月时BCVA的平均变化分别为-0.286、-0.165和-0.151(logMAR)。CMT也分别平均降低了32.72±56.75、57.45±56.48和148.37±98.59μm。I组的平均注射次数显著低于II组和III组(I组与II组、I组与III组、II组与III组比较,P值分别为<0.001、<0.001和0.15)。

结论

12个月的随访结果表明,连续三个月给予玻璃体内雷珠单抗负荷剂量对RAP早期(I期)是一种有效的治疗方法。I期患者的复发率显著低于后期患者。

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