Zandi Souska, Weisskopf Florian, Garweg Justus G, Pfister Isabel B, Pruente Christian, Sutter Florian, Hatz Katja
Ophthalmic Surg Lasers Imaging Retina. 2017 Apr 1;48(4):326-332. doi: 10.3928/23258160-20170329-07.
The aim of this study was to identify the rate of early visual acuity poor responders in patients with neovascular age-related macular degeneration (AMD) after the first intravitreal injection of ranibizumab (Lucentis; Genentech, South San Francisco, CA) and to determine potential predictors for early response.
Patients with choroidal neovascularization secondary to AMD were evaluated before and 1 month after their first ranibizumab treatment. Early poor responders were defined as eyes gaining less than five letters 1 month after the first injection.
Following the first ranibizumab injection, 58% of 84 patients gained five or more letters. Beyond 42% poor responders, 31% displayed foveal retinal pigment epithelium (RPE) atrophy and 89% a loss of the external limiting membrane (ELM) integrity at baseline. However, the amount of intra- and subretinal fluid, pigment epithelial detachment (PED), and subfoveal fibrosis showed a similar distribution between gainers and poor responders.
Early poor responders present with more RPE atrophy, as well as a loss of the ELM integrity at baseline optical coherence tomography. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:326-332.].
本研究旨在确定新生血管性年龄相关性黄斑变性（AMD）患者首次玻璃体内注射雷珠单抗（Lucentis；基因泰克公司，加利福尼亚州南旧金山）后早期视力改善不佳者的比例，并确定早期反应的潜在预测因素。
对继发于AMD的脉络膜新生血管患者在首次雷珠单抗治疗前及治疗后1个月进行评估。早期反应不佳者定义为首次注射后1个月视力提高少于5个字母的眼。
首次注射雷珠单抗后，84例患者中有58%的患者视力提高了5个或更多字母。在42%以上的反应不佳者中，31%在基线时出现黄斑视网膜色素上皮（RPE）萎缩，89%出现外限制膜（ELM）完整性丧失。然而，视网膜内和视网膜下液量、色素上皮脱离（PED）和黄斑下纤维化在视力改善者和反应不佳者之间的分布相似。
早期反应不佳者在基线光学相干断层扫描时表现为更多的RPE萎缩以及ELM完整性丧失。[《眼科手术、激光与视网膜成像》。2017；48：326 - 332。]
