Minami Yoshiro, Nagaoka Taiji, Ishibazawa Akihiro, Yoshida Akitoshi
Department of Ophthalmology, Nayoro City General Hospital, Nishi 7 Minami 8-1, Nayoro, 096-8511, Japan.
Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Japan.
BMC Ophthalmol. 2017 Mar 14;17(1):28. doi: 10.1186/s12886-017-0420-8.
The short-term effects of intravitreal ranibizumab (IVR) on diabetic macular edema (DME) remains unclear. We assessed the short-term effects of IVR on DME.
Eighteen eyes of 14 patients with DME were enrolled in this prospective interventional case series. After intravitreal ranibizumab was injected into treatment-naïve eyes with DME, we measured the foveal thickness (FT) before and 2 h, 1 day, 1 week, and 1 month later and the best-corrected visual acuity (BCVA) at all times except 2 h and compared the changes to baseline (ΔFT and ΔVA).
The mean FT decreased significantly (p < 0.0001) from 452 ± 77 to 429 ± 65 microns after 2 h. The mean logarithm of the minimum angle of resolution BCVA improved significantly (p = 0.032) after 1 month from 0.41 ± 0.24 to 0.32 ± 0.21 (20/51 to 20/42, Snellen equivalent). The ΔFT after 2 h was significantly (r = 0.53, p = 0.025) correlated with the ΔFT after 1 month. The ΔVA after 1 day was significantly (r = 0.59, p = 0.01) correlated with the ΔVA after 1 month.
The structural effects of IVR for DME occurred within 2 h, whereas the functional effects occurred after 1 month. The short-term effects (within 1 day) of IVR may predict the therapeutic outcome 1 month after IVR in patients with DME.
The trial registration number: UMIN000026118 (Feb/13/2017). Retrospectively registered.
玻璃体内注射雷珠单抗(IVR)对糖尿病性黄斑水肿(DME)的短期影响尚不清楚。我们评估了IVR对DME的短期影响。
本前瞻性干预性病例系列纳入了14例DME患者的18只眼。在未接受过治疗的DME眼中玻璃体内注射雷珠单抗后,我们测量了注射前、注射后2小时、1天、1周和1个月时的黄斑中心凹厚度(FT),以及除2小时外所有时间点的最佳矫正视力(BCVA),并将这些变化与基线值(ΔFT和ΔVA)进行比较。
2小时后,平均FT从452±77微米显著下降至429±65微米(p<0.0001)。1个月后,最小分辨角对数BCVA平均显著改善(p = 0.032),从0.41±0.24提高到0.32±0.21(相当于Snellen视力表的20/51至20/42)。2小时后的ΔFT与1个月后的ΔFT显著相关(r = 0.53,p = 0.025)。1天后的ΔVA与1个月后的ΔVA显著相关(r = 0.59,p = 0.01)。
IVR对DME的结构效应在2小时内出现,而功能效应在1个月后出现。IVR的短期效应(1天内)可能预测DME患者IVR治疗1个月后的治疗效果。
试验注册号:UMIN000026118(2017年2月13日)。回顾性注册。