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雷珠单抗治疗特发性脉络膜新生血管膜——我们的经验

Treatment of idiopathic choroidal neovascular membrane with ranibizumab - our experience.

作者信息

Chrapek O, Vostrovská Z, Šínová I, Chrapková B

出版信息

Cesk Slov Oftalmol. 2019 Spring;75(1):25-29. doi: 10.31348/2019/1/3.

Abstract

OBJECTIVE

To evaluate the anatomical and functional outcome of ranibizumab therapy in patients with idiopathic choroidal neovascularization (CNV). File and Methodology: The group consists of 6 patients. Patients were older 18 years but they were under 50 years of age. The monitoring period lasted 12 months. We confirmed active idiopathic CNV in subfoveal position with fluorescein angiography (FAg) and optical coherence tomography (OCT). The activity of idiopathic CNV we demonstrated with leakage of dye by FAg examination. The presence of serous retinal pigment epithelium detachment and / or subretinal fluid and / or intraretinal edema in the form of intraretinal cysts demonstrated activity of CNV on OCT scans. A decrease of the visual acuity under 85 letters was observed at the ETDRS (Early Treatment Diabetic Retinopathy Study) visual acuity chart. After the initial administration of ranibizumab a pro re nata regimen was used. We indicated repeated injection of ranibizumab in patients with signs of activity of idiopathic CNV on OCT scans or by FAg. Also we indicated repeated injection of ranibizumab in patients with new loss of visual acuity on the ETDRS visual acuity chart connected with signs of activity of CNV on OCT scans or by FAg.

RESULTS

On average, we observed the gain of +11 letters on the ETDRS visual acuity chart after 12 months of the follow-up period. On average we observed reduction of central macular thickness -233μm. At the 12th month of follow-up we observed in all patients of our group only inactive scar without exudation. No serous retinal pigment eithelium detachment, subretinal fluid or intraretinal cysts were observed. Only 3 injections of ranibizumab were administered on average to each patient during the 12 months of the follow-up period.

CONCLUSION

In our study, we observed the positive effect of ranibizumab on the course of idiopathic CNV. With ranibizumab treatment we achieved regression of CNV with resorption of macular edema in all patients of our group. With the disappearance of the activity of idiopathic CNV ranibizumab gives real hope to improve visual acuity.

摘要

目的

评估雷珠单抗治疗特发性脉络膜新生血管(CNV)患者的解剖学和功能结局。资料与方法:该组由6例患者组成。患者年龄在18岁以上但未满50岁。监测期持续12个月。我们通过荧光素血管造影(FAg)和光学相干断层扫描(OCT)确认了黄斑中心凹下位置的活动性特发性CNV。我们通过FAg检查中染料渗漏来证明特发性CNV的活动性。视网膜色素上皮浆液性脱离和/或视网膜下液和/或视网膜内囊肿形式的视网膜内水肿的存在在OCT扫描上证明了CNV的活动性。在早期糖尿病性视网膜病变研究(ETDRS)视力表上观察到视力下降至85字母以下。在首次给予雷珠单抗后,采用按需给药方案。对于在OCT扫描或通过FAg显示有特发性CNV活动迹象的患者,我们指示重复注射雷珠单抗。对于在ETDRS视力表上出现新的视力丧失且与OCT扫描或通过FAg显示的CNV活动迹象相关的患者,我们也指示重复注射雷珠单抗。

结果

在随访12个月后,平均而言,我们在ETDRS视力表上观察到视力提高了11个字母。平均而言,我们观察到中心黄斑厚度减少了-233μm。在随访的第12个月,我们在该组所有患者中仅观察到无渗出的非活动性瘢痕。未观察到视网膜色素上皮浆液性脱离、视网膜下液或视网膜内囊肿。在随访的12个月期间,每位患者平均仅注射了3次雷珠单抗。

结论

在我们的研究中,我们观察到雷珠单抗对特发性CNV病程有积极作用。通过雷珠单抗治疗,我们组所有患者的CNV均消退,黄斑水肿吸收。随着特发性CNV活动的消失,雷珠单抗为提高视力带来了真正的希望。

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