a Department of Ophthalmology, Health Sciences University Medical School , Afyonkarahisar , Turkey.
b Department of Ophthalmology, Batman State Hospital , Batman , Turkey.
Curr Eye Res. 2019 Aug;44(8):908-915. doi: 10.1080/02713683.2019.1600195. Epub 2019 Apr 16.
: To study (i) the long-term effects of intravitreal ranibizumab treatment on changes in submacular choroidal thickness and (ii) the relationship between any resulting changes in choroidal thickness and visual outcomes following such treatment in patients with neovascular age-related macular degeneration (n-AMD). : Reviewed were medical records of 30 consecutive, treatment-naïve, patients with unilateral n-AMD (n = 30 eyes) and unaffected fellow eyes (n = 26 eyes) (controls). Monthly injections of 0.5 mg ranibizumab were administered until stabilization of n-AMD, with additional injections as needed over the following 14-mo. Choroidal thickness was determined using enhanced-depth imaging-optical coherence tomography (EDI-OCT) before and after initiation of ranibizumab therapy. Choroidal thickness measurements were generated via manual segmentation. : The mean age of patients was 71.9 ± 7.4 (56-83) years; the mean best-corrected visual acuity (BCVA) of affected eyes improved from 51.1 to 59.4 letters ( < 0.001); and the mean number of injections was 9.16 ± 1.75. Subfoveal choroidal thickness decreased from 208.3 ± 73.7 μm at baseline to 185.3 ± 70.1 μm at mo-14 ( < 0.001), with significant ( < 0.001) decreases at all measured time points. Choroidal thickness also tended to decline in fellow eyes but was only statistically significant nasally 1,000 μm (0.04). Mean changes in choroidal thickness did not correlate with BCVA at mo-14 ( = 0.76). Disciform scars and geographic atrophy ( 0.017), and BCVA ( < 001) at baseline were predictive of visual outcome. Age ( 0.001), reticular drusen ( 0.004), and size of choroidal neovascularized area ( = 0.042) were predictive of decreases in choroidal thickness. : Submacular choroidal thickness appeared to decrease significantly in eyes with n-AMD over a 14-mo period of ranibizumab treatment. No corresponding decrease in choroidal thickness occurred in fellow eyes.
研究（i）玻璃体内雷珠单抗治疗对年龄相关性黄斑变性（AMD）患者脉络膜厚度变化的长期影响，以及（ii）脉络膜厚度变化与雷珠单抗治疗后视力结果之间的关系。
回顾性分析了 30 例（30 只眼）未经治疗的单侧 nAMD 患者（病例组）和 26 只未受影响的对侧眼（对照组）的连续病历资料。每月注射 0.5mg 雷珠单抗，直至 nAMD 稳定，随后在接下来的 14 个月内根据需要追加注射。在开始雷珠单抗治疗前和治疗后，采用增强深度成像光学相干断层扫描（EDI-OCT）检测脉络膜厚度。通过手动分割生成脉络膜厚度测量值。
患者平均年龄为 71.9 ± 7.4（56-83）岁；受影响眼的最佳矫正视力（BCVA）从 51.1 提高到 59.4 个字母（<0.001）；平均注射次数为 9.16 ± 1.75。黄斑中心凹下脉络膜厚度从基线时的 208.3 ± 73.7μm下降至 14 个月时的 185.3 ± 70.1μm（<0.001），各时间点均有显著下降（<0.001）。对侧眼的脉络膜厚度也有下降趋势，但仅在鼻侧 1000μm 处有统计学意义（0.04）。治疗 14 个月时，脉络膜厚度的平均变化与 BCVA 无相关性（ = 0.76）。基线时存在盘状瘢痕和地图状萎缩（<0.017）和 BCVA（<0.001）是视力结果的预测因素。年龄（<0.001）、网状玻璃膜疣（<0.004）和脉络膜新生血管面积大小（ = 0.042）是脉络膜厚度下降的预测因素。
在雷珠单抗治疗 14 个月期间，nAMD 眼的黄斑下脉络膜厚度明显下降，而对侧眼的脉络膜厚度无相应下降。
