Sugimoto Masahiko, Nunome Takayasu, Sakamoto Rie, Kobayashi Maki, Kondo Mineo
Department of Ophthalmology, Mie University Graduate School of Medicine, 2-175 Edobashi, Tsu, 514-8507, Japan.
Graefes Arch Clin Exp Ophthalmol. 2017 Aug;255(8):1543-1550. doi: 10.1007/s00417-017-3692-z. Epub 2017 Jun 28.
To evaluate the effects of unilateral intravitreal ranibizumab (IVR) on the ocular circulation of the fellow eyes.
Fifteen eyes of 15 patients with macular edema (average age 69.6 ± 11.8 years) were studied. Eleven eyes had diabetic macular edema (DME) and four eyes had macular edema associated with a branch retinal vein occlusion. Each eye received 0.5 mg of IVR. The blood circulation on the optic nerve head of the treated and untreated eyes were determined by laser speckle flowgraphy (LSFG, Softcare Co., Ltd) before, 1 day, and 1 week after the IVR. The mean blur rate (MBR) and the relative changes of the MBRs determined as dMBR(%) = 100-(MBR before/MB after) × 100) were evaluated. The central macular thickness (CMT) and the rate of reduction in the thickness (dCMT = 100-(CMT before/CMT after) × 100) were also evaluated.
The mean dMBR was significantly higher in the treated eyes than the untreated eyes at 1 day (-16.4 ± 17.0% vs 2.31 ± 19.3%) and at 1 week (-12.0 ± 14.6% vs 4.50 ± 25.9%) after the IVR (P = 0.02, paired t tests).
These findings indicate that if ranibizumab enters the systemic circulation, the concentration is not high enough to affect the ocular circulation of the fellow eyes.
评估单侧玻璃体内注射雷珠单抗(IVR)对健侧眼眼循环的影响。
对15例黄斑水肿患者(平均年龄69.6±11.8岁)的15只眼进行研究。其中11只眼为糖尿病性黄斑水肿(DME),4只眼为视网膜分支静脉阻塞相关的黄斑水肿。每只眼接受0.5mg的IVR注射。在IVR注射前、注射后1天和1周,通过激光散斑血流图(LSFG,Softcare有限公司)测定治疗眼和未治疗眼视神经乳头的血液循环。评估平均模糊率(MBR)以及MBR的相对变化,其计算公式为dMBR(%) = 100 - (注射前MBR/注射后MBR)×100)。还评估了中心黄斑厚度(CMT)及其厚度减少率(dCMT = 100 - (注射前CMT/注射后CMT)×100)。
IVR注射后1天(-16.4±17.0% vs 2.31±19.3%)和1周(-12.0±14.6% vs 4.50±25.9%)时,治疗眼的平均dMBR显著高于未治疗眼(配对t检验,P = 0.02)。
这些发现表明,如果雷珠单抗进入体循环,其浓度不足以影响健侧眼的眼循环。