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雷珠单抗治疗 50 岁以下患者的中心性和分支性视网膜静脉阻塞继发黄斑水肿。

Ranibizumab for Macular Edema Secondary to Central and Branch Retinal Vein Occlusion in Patients Younger Than 50 Years of Age.

机构信息

Department of Ophthalmology, University Vita-Salute, Scientific Institute San Raffaele, Milan, Italy.

Eye Clinic, Department of Clinical and Biomedical Sciences, Luigi Sacco Hospital, University of Milan, Milan, Italy.

出版信息

Biomed Res Int. 2020 Jun 17;2020:4747696. doi: 10.1155/2020/4747696. eCollection 2020.

Abstract

BACKGROUND

To determine the effectiveness of intravitreal ranibizumab (IVR) approach over 1-year follow-up in patients younger than 50 years old with central and branch retinal vein occlusion (RVO) complicated by macular edema (ME).

METHODS

Prospective, open-label case series. Patients initiating IVR injections from January 2015 to May 2017 were consecutively recruited. Each patient underwent monthly ophthalmic examination and structural OCT over 12 months. A single IVR injection was administered at baseline, followed by a PRN regimen. Outcome measures are best-corrected visual acuity (BCVA); central foveal thickness (CFT); number of IVR injections; subretinal fluid (SRF); epiretinal membrane; and outer retinal layer (ORL) status.

RESULTS

Thirty-eight patients (27 males) were included in the study. At follow-up, mean BCVA improved from 0.40 ± 0.17 to 0.10 ± 0.10 LogMAR in patients with central RVO and from 0.39 ± 0.19 to 0.19 ± 0.07 LogMAR in those with branch RVO, with 20 eyes gaining ≥3 ETDRS lines. In addition, mean CFT significantly decreased in both subgroups at the end of follow-up. All patients with SRF at baseline (9) disclosed complete resolution after 1 year. Likewise, ORL appeared reconstituted in most cases. At 12 months, 3.6 ± 2.4 and 4.4 ± 2.4 IVR injections were required for central and branch RVO, respectively, with only 5 eyes showing ME persistence.

CONCLUSIONS

Our study indicates that IVR injections can be a valid therapeutic option in patients under 50 years of age with ME secondary to RVO.

摘要

背景

为了确定在年龄小于 50 岁的伴有黄斑水肿(ME)的中心性和分支性视网膜静脉阻塞(RVO)患者中,在 1 年的随访中玻璃体内雷珠单抗(IVR)治疗的有效性。

方法

前瞻性、开放标签病例系列研究。连续招募了从 2015 年 1 月至 2017 年 5 月接受 IVR 注射的患者。每位患者在 12 个月内每月接受眼科检查和结构 OCT。在基线时进行单次 IVR 注射,随后采用 PRN 方案。观察指标包括最佳矫正视力(BCVA);中心视网膜厚度(CFT);IVR 注射次数;视网膜下液(SRF);视网膜内膜;以及外层视网膜(ORL)状态。

结果

本研究纳入了 38 名患者(27 名男性)。在随访时,与中央 RVO 患者相比,中央 RVO 患者的平均 BCVA 从 0.40±0.17 提高到 0.10±0.10 LogMAR,分支 RVO 患者的平均 BCVA 从 0.39±0.19 提高到 0.19±0.07 LogMAR,有 20 只眼提高了≥3 ETDRS 行。此外,在两个亚组中,在随访结束时,平均 CFT 均显著降低。所有基线时存在 SRF(9 只眼)的患者在 1 年后均完全消退。同样,大多数病例的 ORL 也得到重建。在 12 个月时,中央 RVO 和分支 RVO 分别需要 3.6±2.4 和 4.4±2.4 次 IVR 注射,只有 5 只眼出现 ME 持续存在。

结论

我们的研究表明,对于年龄小于 50 岁的伴有 RVO 所致 ME 的患者,IVR 注射可能是一种有效的治疗选择。

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