Stepanov Alexandr, Pencak Martin, Nemcansky Jan, Matuskova Veronika, Stredova Marketa, Beran David, Studnicka Jan
Department of Ophthalmology, Faculty of Medicine in Hradec Kralove, Charles University in Prague and University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.
Department of Ophthalmology, Third Faculty of Medicine, Charles University in Prague and University Hospital Kralovske Vinohrady, Prague, Czech Republic.
J Ophthalmol. 2020 May 12;2020:3076596. doi: 10.1155/2020/3076596. eCollection 2020.
A retrospective evaluation of the results of treatment of myopic choroidal neovascularization (mCNV) with intravitreal injections of ranibizumab in a (PRN) regimen in three groups of patients distributed according to axial length.
The paper presents a retrospective multicenter study carried out with the cooperation of several Departments of Ophthalmology in the Czech Republic. The study included 60 eyes of 60 patients suffering from mCNV, divided according to axial length into three groups. The first group consisted of 20 patients with an axial length of the eyes shorter than 28 mm (Group 1), the second group included 27 patients with axial lengths ranging from 28 mm to 29.81 mm (Group 2), and 13 patients had axial lengths longer than 30 mm (Group 3). All patients were first administered 3 initial intravitreal ranibizumab injections at monthly intervals (loading phase), and other injections were administered according to a PRN treatment regimen. Patients were evaluated before treatment and then at intervals of 3, 6, 9, and 12 months. The effect of ranibizumab treatment on the functional and morphological parameters of the affected eye was evaluated.
The average baseline BCVA ± SD in Group 1 was 52.6 ± 12.5 letters of ETDRS optotypes, and at the end of the one-year follow-up, it was 63.3 ± 11.8 letters. The average baseline of CRT ± SD in this group was 377.4 ± 80.0 m, and in the 12th month, it was 311.1 ± 63.7 m. The average baseline BCVA ± SD in Group 2 was 50.2 ± 9.0 ETDRS letters, and at the end of the follow-up, it was 60 ± 12.4 letters. The average baseline of CRT ± SD in Group 2 was 391.2 ± 85.2 m, and in the 12th month, it was 323.9 ± 91.2 m. In Group 3, the average baseline of BCVA was 48.5 ± 14.5 ETDRS letters, and at the end of the one-year follow-up, it was 55.7 ± 16.1 letters. The average baseline CRT ± SD for Group 3 was 342.1 ± 94.9 m, and after 12 months, it was 287.8 ± 88.4 m. An improvement of BCVA by ≥15 letters of ETDRS optotypes was achieved by 3 patients of 20 (15%) in Group 1, by 5 patients of 27 (18.5%) in Group 2, and by 3 patients of 13 (23.1%) in Group 3. All these changes were statistically significant in comparison with the input values ( < 0.05).
Ranibizumab treatment in patients with mCNV in our study resulted in statistically significant improvement in BCVA and a decrease in CRT in all groups of patients. Our results from a routine clinical practice correspond with the results of large clinical studies; we confirm a particularly good effect of treatment in patients with axial lengths of the eye smaller than 28 mm.
回顾性评估玻璃体内注射雷珠单抗按需给药方案治疗不同眼轴长度分组的近视性脉络膜新生血管（mCNV）患者的疗效。
本文介绍了一项在捷克共和国多个眼科部门合作下开展的回顾性多中心研究。该研究纳入了60例mCNV患者的60只眼，根据眼轴长度分为三组。第一组由20例眼轴长度小于28mm的患者组成（第1组），第二组包括27例眼轴长度在28mm至29.81mm之间的患者（第2组），13例患者眼轴长度大于30mm（第3组）。所有患者首先每月接受3次初始玻璃体内雷珠单抗注射（负荷期），其他注射根据按需治疗方案进行。在治疗前以及之后3、6、9和12个月对患者进行评估。评估雷珠单抗治疗对患眼功能和形态学参数的影响。
第1组的平均基线ETDRS视力表最佳矫正视力（BCVA）±标准差为52.6±12.5个字母，在一年随访结束时为63.3±11.8个字母。该组中央视网膜厚度（CRT）的平均基线±标准差为377.4±80.0μm，在第12个月时为311.1±63.7μm。第2组的平均基线BCVA±标准差为50.2±9.0个ETDRS字母，随访结束时为60±12.4个字母。第2组CRT的平均基线±标准差为391.2±85.2μm，在第12个月时为323.9±91.2μm。在第3组中，BCVA的平均基线为48.5±14.5个ETDRS字母，在一年随访结束时为55.7±16.1个字母。第3组CRT的平均基线±标准差为342.1±94.9μm，12个月后为287.8±88.4μm。第1组20例患者中有3例（15%）ETDRS视力表最佳矫正视力提高≥15个字母，第2组27例患者中有5例（18.5%），第3组13例患者中有3例（23.1%）。与输入值相比，所有这些变化均具有统计学意义（P<0.05）。
在我们的研究中，雷珠单抗治疗mCNV患者使所有组患者的最佳矫正视力有统计学意义的提高，中央视网膜厚度降低。我们常规临床实践的结果与大型临床研究的结果一致；我们证实眼轴长度小于28mm的患者治疗效果特别好。
