假性剥脱的存在对接受玻璃体内注射雷珠单抗治疗的黄斑变性患者眼压和视网膜神经纤维层厚度的影响。
Effects of the Presence of Pseudoexfoliation on Intraocular Pressure and Retinal Nerve Fiber Layer Thickness in Patients with Macular Degeneration Receiving Intravitreal Ranibizumab.
作者信息
Daldal Hatice, Yilmaz Melike Balikoglu
机构信息
Department of Ophthalmology, Faculty of Medicine, Usak University, Usak 64000, Turkey.
Department of Ophthalmology, Faculty of Medicine, İzmir Katip Celebi University, İzmir 35620, Turkey.
出版信息
Clin Pract. 2022 Jan 19;12(1):78-83. doi: 10.3390/clinpract12010009.
AIMS
In the present study, we aimed to compare the effect of intravitreal ranibizumab (IVR) treatment on intraocular pressure (IOP) and retinal nerve fiber layer (RNFL) thickness in patients with age-related macular degeneration (AMD) with and without pseudoexfoliation (PEX).
MATERIALS AND METHODS
A total of 24 patients, 12 with PEX (12 eyes) and 12 without PEX (12 eyes), receiving IVR treatment for neovascular AMD between June 2017 and June 2019, were included in the study. Exclusion criteria were composed of the history of glaucoma, uveitis, intravitreal steroid administration, pars plana vitrectomy surgery, and less than three IVR injections. Such criteria as age, gender, follow-up times, number of injections administered, IOP, and RNFL thickness before the first injection and one month after the last injection were also recorded.
RESULTS
Age, gender, follow-up time, and the number of injections were similar in groups with and without PEX ( > 0.05). While mean post-treatment IOP values were not significantly higher in the PEX group (14.50 ± 3.06 vs. 12.91 ± 1.83 mmHg, = 0.065), the values were significant for the non-PEX group (13.25 ± 2.76 vs. 11.83 ± 2.69 mmHg, = 0.01), and these values were within normal IOP limits. Additionally, RNFL thickness was significantly thinner after treatment in both groups (91.41 ± 7.14 vs. 94.00 ± 6.76 in those with PEX; 95.58 ± 5.91 vs. 97.66 ± 6.89 in those without PEX; < 0.05). The decrease in RNFL thickness in the PEX group was 2.58 ± 1.62 µ and in the non-PEX group was 2.08 ± 1.98 µ. However, there was no statistically significant difference between the two groups in terms of RNFL thinning ( = 0.505).
DISCUSSION
Ranibizumab may reduce RNFL thickness in patients with PEX. Longer-term studies including larger populations are necessary for understanding IOP and RNFL changes after anti-vascular endothelial growth factor (anti-VEGF) injection.
目的
在本研究中，我们旨在比较玻璃体内注射雷珠单抗（IVR）治疗对伴有和不伴有假性剥脱（PEX）的年龄相关性黄斑变性（AMD）患者眼压（IOP）和视网膜神经纤维层（RNFL）厚度的影响。
材料与方法
本研究纳入了2017年6月至2019年6月期间接受IVR治疗新生血管性AMD的24例患者，其中12例伴有PEX（12只眼），12例不伴有PEX（12只眼）。排除标准包括青光眼病史、葡萄膜炎、玻璃体内注射类固醇、玻璃体切割手术以及少于三次IVR注射。还记录了年龄、性别、随访次数、注射次数、首次注射前和最后一次注射后1个月的IOP和RNFL厚度等指标。
结果
伴有和不伴有PEX的组在年龄、性别、随访时间和注射次数方面相似（P>0.05）。虽然PEX组治疗后的平均IOP值没有显著升高（14.50±3.06 vs. 12.91±1.83 mmHg，P=0.065），但非PEX组的IOP值有显著变化（13.25±2.76 vs. 11.83±2.69 mmHg，P=0.01），且这些值均在正常IOP范围内。此外，两组治疗后RNFL厚度均显著变薄（伴有PEX者：91.41±7.14 vs. 94.00±6.76；不伴有PEX者：95.58±5.91 vs. 97.66±6.89；P<0.05）。PEX组RNFL厚度的减少为2.58±1.62 µm，非PEX组为2.08±1.98 µm。然而，两组在RNFL变薄方面没有统计学显著差异（P=0.505）。
讨论
雷珠单抗可能会降低伴有PEX患者的RNFL厚度。需要开展纳入更多人群的长期研究来了解抗血管内皮生长因子（抗VEGF）注射后IOP和RNFL的变化。
Zotero 插件