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玻璃体内注射雷珠单抗治疗近视性脉络膜新生血管的五年疗效

FIVE-YEAR OUTCOMES OF INTRAVITREAL INJECTION OF RANIBIZUMAB FOR THE TREATMENT OF MYOPIC CHOROIDAL NEOVASCULARIZATION.

作者信息

Wu Tsung-Tien, Kung Ya-Hsin

机构信息

Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung; Department of Ophthalmology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.

出版信息

Retina. 2017 Nov;37(11):2056-2061. doi: 10.1097/IAE.0000000000001453.

Abstract

PURPOSE

To evaluate the 5-year outcomes, efficacy, and safety of intravitreal ranibizumab injections for the treatment of myopic choroidal neovascularization.

METHODS

The medical records of 18 consecutive eyes of 14 patients who received intravitreal injections of ranibizumab for myopic choroidal neovascularization with a follow-up of 5 years were retrospectively reviewed. Outcomes included best-corrected visual acuity, total number of treatments, and complications.

RESULTS

The average number of injections over 5 years was 4.56 ± 3.52. Ten eyes (55.56%) had no need for treatment after the first year. Mean best-corrected visual acuity improved from 0.59 ± 0.47 logarithm of the minimum angle of resolution (Snellen equivalent, 6/24) at baseline to 0.32 ± 0.35 logarithm of the minimum angle of resolution (Snellen equivalent, 6/13) at 1 year, and to 0.38 ± 0.42 logarithm of the minimum angle of resolution (Snellen equivalent, 6/15) at 2 years (P = 0.001 and 0.020, respectively; paired t-test). After 2 years, although mean best-corrected visual acuity remained better than baseline, the difference was not statistically significant. At 5 years, vision improved by at least 1 line for 61.11% of eyes and by more than 3 lines for 33.33%. The final visual acuity of 2 eyes was worse than baseline because of disease activity and profound chorioretinal atrophy, which increased in six eyes. No complications were noted.

CONCLUSION

Intravitreal ranibizumab was safe and effective for treating myopic choroidal neovascularization. Only 44% of eyes required retreatment after the first year, and vision improved in more than 60% of eyes over 5 years.

摘要

目的

评估玻璃体内注射雷珠单抗治疗近视性脉络膜新生血管的5年疗效、安全性。

方法

回顾性分析14例接受玻璃体内注射雷珠单抗治疗近视性脉络膜新生血管患者的18只眼的病历,随访5年。观察指标包括最佳矫正视力、治疗总次数及并发症。

结果

5年内平均注射次数为4.56±3.52次。10只眼(55.56%)在第1年后无需治疗。平均最佳矫正视力从基线时的0.59±0.47最小分辨角对数(Snellen等效值,6/24)提高到1年时的0.32±0.35最小分辨角对数(Snellen等效值,6/13),2年时提高到0.38±0.42最小分辨角对数(Snellen等效值,6/15)(分别为P = 0.001和0.020;配对t检验)。2年后,尽管平均最佳矫正视力仍优于基线,但差异无统计学意义。5年时,61.11%的患眼视力至少提高1行,33.33%的患眼视力提高超过3行。2只患眼的最终视力因疾病活动和严重脉络膜视网膜萎缩而低于基线水平,6只患眼出现病情进展。未观察到并发症。

结论

玻璃体内注射雷珠单抗治疗近视性脉络膜新生血管安全有效。仅44%的患眼在第1年后需要再次治疗,5年时超过60%的患眼视力得到改善。

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