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雷珠单抗与地塞米松植入物治疗视网膜分支静脉阻塞继发黄斑水肿的两年疗效

Ranibizumab versus Dexamethasone Implant in Macular Edema Secondary to Branch Retinal Vein Occlusion: Two-year Outcomes.

作者信息

Ozkaya Abdullah, Tarakcioglu Hatice Nur, Tanir Ipek

机构信息

Beyoglu Eye Training and Research Hospital, Istanbul, Turkey *

出版信息

Optom Vis Sci. 2018 Dec;95(12):1149-1154. doi: 10.1097/OPX.0000000000001306.

Abstract

SIGNIFICANCE

We compared the 24-month outcomes of ranibizumab and dexamethasone implants in treatment-naive branch retinal vein occlusion patients. Ranibizumab was effective in improving visual outcomes, whereas the dexamethasone implant was not.

PURPOSE

The aim of this study was to compare the 2-year real-world outcomes of intravitreal ranibizumab with dexamethasone implants in patients with macular edema secondary to branch retinal vein occlusion.

METHODS

The treatment-naive branch retinal vein occlusion patients with macular edema who were treated with intravitreal ranibizumab or dexamethasone implant were included retrospectively. Primary outcome measures were the change in best-corrected visual acuity and central retinal thickness.

RESULTS

Eighty-seven eyes of 87 patients were included. Mean ± SD best-corrected visual acuity in the intravitreal ranibizumab group at baseline and 24 months was 0.64 ± 0.48 and 0.49 ± 0.44 logMAR (P < .05). Mean ± SD best-corrected visual acuity in the intravitreal dexamethasone implant group at baseline and 24 months was 0.98 ± 0.56 and 0.92 ± 0.61 logMAR (P > .05). Mean ± SD central retinal thickness in the intravitreal ranibizumab group at baseline and 24 months was 530 ± 150 and 337 ± 103 μm (P < .05). Mean ± SD central retinal thickness in the intravitreal dexamethasone implant group at baseline and 24 months was 591 ± 113 and 335 ± 99 μm (P < .05). Mean ± SD number of injections at 24 months was 5.6 ± 1.8 in the intravitreal ranibizumab group and 2.7 ± 1.1 in the dexamethasone implant group (P < .0001). Progression in lens opacity was detected in 5.7% of the phakic patients in the intravitreal ranibizumab group and 46.1% of them in the dexamethasone implant group (P < .0001). None of the patients in the intravitreal ranibizumab group and 9 (22.0%) of 41 patients in the dexamethasone implant group showed an increase of more than 10 mmHg in intraocular pressure.

CONCLUSIONS

Ranibizumab was effective in the treatment of macular edema secondary to branch retinal vein occlusion in both visual and anatomical outcomes; however, dexamethasone implant was effective only in anatomical outcomes.

摘要

意义

我们比较了初治的视网膜分支静脉阻塞患者接受雷珠单抗和地塞米松植入物治疗24个月的结果。雷珠单抗在改善视力方面有效,而地塞米松植入物则无效。

目的

本研究的目的是比较玻璃体内注射雷珠单抗与地塞米松植入物治疗视网膜分支静脉阻塞继发黄斑水肿患者的2年真实世界疗效。

方法

回顾性纳入初治的视网膜分支静脉阻塞继发黄斑水肿且接受玻璃体内注射雷珠单抗或地塞米松植入物治疗的患者。主要观察指标为最佳矫正视力和视网膜中央厚度的变化。

结果

纳入87例患者的87只眼。玻璃体内注射雷珠单抗组基线和24个月时的平均±标准差最佳矫正视力分别为0.64±0.48和0.49±0.44 logMAR(P<0.05)。玻璃体内注射地塞米松植入物组基线和24个月时的平均±标准差最佳矫正视力分别为0.98±0.56和0.92±0.61 logMAR(P>0.05)。玻璃体内注射雷珠单抗组基线和24个月时的平均±标准差视网膜中央厚度分别为530±150和337±103μm(P<0.05)。玻璃体内注射地塞米松植入物组基线和24个月时的平均±标准差视网膜中央厚度分别为591±113和335±99μm(P<0.05)。玻璃体内注射雷珠单抗组24个月时的平均±标准差注射次数为5.6±1.8次,地塞米松植入物组为2.7±1.1次(P<0.0001)。玻璃体内注射雷珠单抗组5.7%的有晶状体患者出现晶状体混浊进展,地塞米松植入物组为46.1%(P<0.0001)。玻璃体内注射雷珠单抗组无患者眼压升高超过10 mmHg,地塞米松植入物组41例患者中有9例(22.0%)出现眼压升高超过10 mmHg。

结论

雷珠单抗在治疗视网膜分支静脉阻塞继发黄斑水肿的视力和解剖学结果方面均有效;然而,地塞米松植入物仅在解剖学结果方面有效。

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