Kawamura Mihoko, Hirano Yoshio, Yoshida Munenori, Mizutani Takeshi, Sugitani Kazuhiko, Yasukawa Tsutomu, Ogura Yuichiro
Department of Ophthalmology & Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan,
Clin Ophthalmol. 2018 Aug 20;12:1487-1494. doi: 10.2147/OPTH.S170698. eCollection 2018.
The aim of this study is to report the 6-month results after one intravitreal ranibizumab (IVR) injection followed by pro re nata dosing for macular edema (ME) after branch retinal vein occlusion.
The inclusion criteria included a minimal patient age of 18 years, 20 letters or more best-corrected visual acuity (BCVA) (Early Treatment Diabetic Retinopathy Study [ETDRS] score, 77 letters or less), and central retinal thickness (CRT) of 250 microns or more. The primary outcome measure was the mean BCVA change from baseline at month 6; the secondary outcomes were mean changes in CRT, residual ME, and microaneurysm formation.
Twenty patients were enrolled from March 2014 through October 2016 at Nagoya City University Hospital. The baseline mean ETDRS letters and CRT were 63.1 and 500 microns, respectively; mean time from symptom onset to initial therapy was 1.80 months; and mean ETDRS gain and CRT reduction were 15.2 letters and 230 microns, respectively. The percentages of patients with Snellen equivalent BCVAs of 20/40 (70 ETDRS letters) or better and 20/20 (85 ETDRS letters) were 90% and 15%, respectively. Residual ME and microaneurysms were observed in 85% and 35% of patients. Microaneurysm formation was associated with delayed initial therapy.
Prompt initiation of IVR injection provided a better visual prognosis at month 6 and suppressed the microaneurysm formation.
本研究旨在报告玻璃体内注射一次雷珠单抗(IVR),随后根据需要对视网膜分支静脉阻塞后黄斑水肿(ME)进行给药治疗6个月后的结果。
纳入标准包括患者年龄最小18岁、最佳矫正视力(BCVA)为20个字母或更高(早期糖尿病性视网膜病变研究[ETDRS]评分,77个字母或更低)以及中心视网膜厚度(CRT)为250微米或更厚。主要结局指标是第6个月时BCVA相对于基线的平均变化;次要结局指标是CRT、残余ME和微动脉瘤形成的平均变化。
2014年3月至2016年10月期间,名古屋市立大学医院共纳入20例患者。基线时ETDRS字母评分和CRT的平均值分别为63.1和500微米;从症状出现到初始治疗的平均时间为1.80个月;ETDRS评分平均提高和CRT平均降低分别为15.2个字母和230微米。Snellen等效BCVA为20/40(70个ETDRS字母)或更好以及20/20(85个ETDRS字母)的患者百分比分别为90%和15%。85%的患者观察到残余ME,35%的患者观察到微动脉瘤。微动脉瘤形成与初始治疗延迟有关。
及时开始IVR注射在第6个月时提供了更好的视觉预后,并抑制了微动脉瘤形成。