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LAPTOP 研究中光动力疗法或雷珠单抗治疗息肉样脉络膜血管病变的长期疗效。

Long-term results of photodynamic therapy or ranibizumab for polypoidal choroidal vasculopathy in LAPTOP study.

机构信息

Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Japan

Department of Ophthalmology, Kobe City Medical Center General Hospital, Kobe, Japan.

出版信息

Br J Ophthalmol. 2019 Jun;103(6):844-848. doi: 10.1136/bjophthalmol-2018-312419. Epub 2018 Aug 4.

Abstract

BACKGROUND/AIM: We previously reported that ranibizumab performed better on visual prognosis than photodynamic therapy (PDT) in a Ranibizumab (ucentis) nd hotodynamic herapy n olypoidal choroidal vasculopathy (LAPTOP) study. To determine if the first-choice treatment, either PDT or intravitreal ranibizumab, has a long-term effect in patients with polypoidal choroidal vasculopathy (PCV).

METHODS

We reviewed medical records of patientsrandomised to either PDT (29 eyes) or ranibizumab (27 eyes) from July 2009 to June 2011 in LAPTOP study. Retreatment or switching to other treatments were at the investigator's discretion after release from the 2-year LAPTOP study up to 5years. We evaluated visual acuity (VA), continuity of initial treatment, percentage of dry macula achievement and macular atrophy at 5 years.

RESULTS

The logarithm of minimal angle of resolution VA was 0.56 in the PDT and 0.44 in the ranibizumab groups at baseline (p=0.101) and was 0.55 and 0.28 at 5years, respectively (p<0.05). More than 70% of the patients converted to aflibercept in following years. Achievement percentages of dry macula were 74% (PDT) and 63% (ranibizumab) at 5years, and macular atrophy was detected in 78% (PDT) and 60% (ranibizumab) with a mean area of 7.7 and 3.5 mm, respectively (p=0.155).

CONCLUSIONS

The better VA in the initial ranibizumab group compared with the PDT group at 2 years was retained at the 5-year follow-up.

摘要

背景/目的:我们之前报道过,在 Ranibizumab(雷珠单抗)和光动力疗法(PDT)治疗息肉状脉络膜血管病变(PCV)的研究中,雷珠单抗在视力预后方面的表现优于 PDT。为了确定 PCV 患者的首选治疗方法(PDT 或玻璃体内雷珠单抗)是否具有长期效果。

方法

我们回顾了 2009 年 7 月至 2011 年 6 月 LAPTOP 研究中随机分配至 PDT(29 只眼)或雷珠单抗(27 只眼)的患者的病历。在 2 年的 LAPTOP 研究结束后,根据研究者的判断,患者可以接受再治疗或转为其他治疗方法,最长随访时间为 5 年。我们评估了 5 年时的视力(VA)、初始治疗的连续性、干性黄斑区达标率和黄斑萎缩率。

结果

PDT 组和雷珠单抗组的基线最小分辨角对数视力分别为 0.56 和 0.44(p=0.101),5 年时分别为 0.55 和 0.28(p<0.05)。在随后的几年中,超过 70%的患者转为使用阿柏西普。5 年时干性黄斑区达标率分别为 74%(PDT)和 63%(雷珠单抗),黄斑萎缩发生率分别为 78%(PDT)和 60%(雷珠单抗),平均面积分别为 7.7 和 3.5mm(p=0.155)。

结论

与 PDT 组相比,雷珠单抗组在 2 年时的 VA 更好,在 5 年随访时仍保持。

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