Gu Xiaoya, Yu Xiaobing, Dai Hong
Department of Ophthalmology, Beijing Hospital, National Center of Gerontology, No.1 Dahua Road, Dongdan, Dongcheng District, Beijing, China.
BMC Ophthalmol. 2019 Jul 19;19(1):153. doi: 10.1186/s12886-019-1156-4.
There is no consensus on the optimal initial treatment for polypoidal choroidal vasculopathy (PCV). Our study aimed to report the efficacy of repeated injections of intravitreal ranibizumab with or without photodynamic therapy for the treatment of PCV and to determine the possible factors predictive of visual outcomes.
The results of the initial treatment of 40 patients with PCV with 3 monthly injections of ranibizumab were retrospectively reviewed. We compared the results in terms of the best corrected visual acuity (BCVA), the central retinal thickness (CRT), the number of injections, the regression rates of polyps and the rates of the reduction of subretinal fluid.
At the 3-month follow-up, the mean BCVA was significantly increased by 7.3 ± 12.4 letters compared to baseline (p < 0.01). At the 12-month follow-up, the mean BCVA was increased by 3.4 ± 15.4 letters compared to baseline, and there was no significant difference (p > 0.05). The mean CRT at the 12-month follow-up was 593.58 ± 243.64 μm, with an average decrease of 101.55 ± 256.07 μm compared to baseline (p < 0.01). Fifteen eyes (18.8%) showed the complete regression of polyps, and 22 eyes (27.5%) showed a reduction in polyps. The baseline VA, the reduction in subretinal fluids and the greatest lesion diameter were significant independent factors that were predictive of improved VA at the final follow-up.
Three monthly injections of ranibizumab as an initial treatment could significantly improve VA in PCV patients in the short term. At 12 months postinjection, ranibizumab treatment could stabilize VA in most PCV patients. The baseline VA, the reduction in subretinal fluids and the greatest lesion diameter were predictive factors for the relative improvement of VA at the final follow-up.
对于息肉样脉络膜血管病变（PCV）的最佳初始治疗方法尚无共识。我们的研究旨在报告重复玻璃体内注射雷珠单抗联合或不联合光动力疗法治疗PCV的疗效，并确定预测视力预后的可能因素。
回顾性分析40例PCV患者每月3次注射雷珠单抗的初始治疗结果。我们比较了最佳矫正视力（BCVA）、视网膜中央厚度（CRT）、注射次数、息肉消退率和视网膜下液减少率等结果。
在3个月随访时，平均BCVA较基线显著提高7.3±12.4个字母（p<0.01）。在12个月随访时，平均BCVA较基线提高3.4±15.4个字母，无显著差异（p>0.05）。12个月随访时的平均CRT为593.58±243.64μm，与基线相比平均降低101.55±256.07μm（p<0.01）。15只眼（18.8%）息肉完全消退，22只眼（27.5%）息肉减少。基线视力、视网膜下液减少和最大病变直径是预测最终随访时视力改善的显著独立因素。
每月3次注射雷珠单抗作为初始治疗可在短期内显著改善PCV患者的视力。注射后12个月，雷珠单抗治疗可使大多数PCV患者的视力稳定。基线视力、视网膜下液减少和最大病变直径是最终随访时视力相对改善的预测因素。
