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雷珠单抗治疗糖尿病性黄斑水肿患者2年视力的结局及预测因素

Outcome and Predictors for 2-Year Visual Acuity in Eyes with Diabetic Macular Edema Treated with Ranibizumab.

作者信息

Eski Yucel Ozlem, Birinci Hakki, Sullu Yuksel

机构信息

Department of Ophthalmology, Medical Faculty, Ondokuz Mayis University, Samsun, Turkey.

出版信息

J Ocul Pharmacol Ther. 2019 May;35(4):229-234. doi: 10.1089/jop.2018.0082. Epub 2019 Mar 21.

Abstract

To determine the role of baseline characteristics in predicting visual outcome in patients with diabetic macular edema (DME) treated with ranibizumab. A review was carried out of the charts of 97 eyes that received pro re nata (PRN) intravitreal ranibizumab (IR) 0.5 mg treatment for DME. The change in the mean best-corrected visual acuity (BCVA) was analyzed. The baseline demographics and ocular and optic coherence tomography findings were analyzed to determine the association with the 2-year visual acuity (VA). BCVA increased from 0.54 ± 0.2 (0.05-1.0) to 0.41 ± 0.3 (0.0-1.0) log of the minimum angle of resolution ( < 0.001). Age ( = 0.012), gender ( = 0.018), baseline BCVA ( < 0.001), presence of leaking microaneurysms (MA) ( = 0.018), development of vitreomacular traction (VMT) ( = 0.001), development of posterior vitreous detachment (PVD) ( = 0.040), and disruption of ellipsoid zone (EZ) ( = 0.007) were found as predictors of 2-year VA. There was no association between visual outcome and the other characteristics. PRN treatment of IR provides significant benefits in VA gain and anatomic improvement in eyes with DME. Older age, female sex, lower baseline VA, VMT development, and EZ disruption are predictors for the poor final VA. Development of PVD and leaking MA are predictors for the good final VA.

摘要

确定基线特征在预测接受雷珠单抗治疗的糖尿病性黄斑水肿(DME)患者视力预后中的作用。对97只接受按需(PRN)玻璃体内注射0.5mg雷珠单抗(IR)治疗DME的眼睛的病历进行了回顾。分析了平均最佳矫正视力(BCVA)的变化。分析基线人口统计学、眼部和光学相干断层扫描结果,以确定与2年视力(VA)的相关性。BCVA从最小分辨角对数的0.54±0.2(0.05-1.0)提高到0.41±0.3(0.0-1.0)(<0.001)。年龄(=0.012)、性别(=0.018)、基线BCVA(<0.001)、渗漏性微动脉瘤(MA)的存在(=0.018)、玻璃体黄斑牵拉(VMT)的发生(=0.001)、玻璃体后脱离(PVD)的发生(=0.040)以及椭圆体带(EZ)的破坏(=0.007)被发现是2年VA的预测因素。视力预后与其他特征之间无相关性。PRN方案的IR治疗在DME患者的VA改善和解剖结构改善方面提供了显著益处。年龄较大、女性、基线VA较低、VMT发生以及EZ破坏是最终视力差的预测因素。PVD的发生和渗漏性MA是最终视力良好的预测因素。

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