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每三个月玻璃体内注射雷珠单抗治疗三个月后渗出性年龄相关性黄斑变性的再治疗

Retreatment of Exudative Age-Related Macular Degeneration after Loading 3-Monthly Intravitreal Ranibizumab.

作者信息

Sugiyama Atsushi, Sakurada Yoichi, Honda Shigeru, Miki Akiko, Matsumiya Wataru, Yoneyama Seigo, Kikushima Wataru, Iijima Hiroyuki

机构信息

Department of Ophthalmology, Faculty of Medicine, University of Yamanashi, Chuo, Japan.

出版信息

Ophthalmologica. 2018;239(1):52-59. doi: 10.1159/000480439. Epub 2017 Oct 19.

Abstract

PURPOSE

The aim of this study was to investigate the clinical implications of required retreatment after 3-monthly intravitreal ranibizumab (IVR) injections followed by as-needed reinjections up to 5 years in eyes with exudative age-related macular degeneration (AMD).

METHODS

A retrospective cohort study was conducted for 165 treatment-naïve eyes from 165 patients with exudative AMD. Visual changes were investigated in terms of the required retreatments.

RESULTS

Retreatment-free proportions were 37.0, 23.7, 16.6, 12.1, and 10.5% at 12, 24, 36, 48, and 60 months, respectively. Visual changes were significantly better in eyes which did not require retreatment at every yearly checkpoint within the 5 years. A multivariate logistic regression analysis revealed that requirement of additional IVR treatments in the first 12-24 months was associated with the T allele (risk allele) of ARMS2 A69S (p = 0.010 and 0.015, respectively). Cox regression analysis revealed that older age (p = 0.046) and the T allele of ARMS2 A69S (p = 0.036) were associated with required retreatment within the 5-year follow-up period.

CONCLUSIONS

Age and the T allele of ARMS2 A69S are the risk factors requiring retreatments, leading to poor visual change in eyes with exudative AMD following the initial 3-monthly IVR.

摘要

目的

本研究旨在探讨在渗出性年龄相关性黄斑变性(AMD)患者眼中,每月玻璃体腔注射雷珠单抗(IVR)3个月,随后根据需要再注射长达5年之后进行再次治疗的临床意义。

方法

对165例初治的渗出性AMD患者的165只眼进行回顾性队列研究。根据所需的再次治疗情况调查视力变化。

结果

在12、24、36、48和60个月时,无需再次治疗的比例分别为37.0%、23.7%、16.6%、12.1%和10.5%。在5年期间每年检查点无需再次治疗的眼中,视力变化明显更好。多因素逻辑回归分析显示,在最初12 - 24个月内需要额外IVR治疗与ARMS2 A69S的T等位基因(风险等位基因)相关(p分别为0.010和0.015)。Cox回归分析显示,年龄较大(p = 0.046)和ARMS2 A69S的T等位基因(p = 0.036)与5年随访期内需要再次治疗相关。

结论

年龄和ARMS2 A69S的T等位基因是需要再次治疗的危险因素,导致最初每月一次IVR治疗后的渗出性AMD患者视力变化不佳。

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