[Combination of Intravitreal rTPA, gas and ranibizumab for extensive subfoveal haemorrhages secondary to neovascular age-related macular degeneration].
[Combination of Intravitreal rTPA, gas and ranibizumab for extensive subfoveal haemorrhages secondary to neovascular age-related macular degeneration].
复制标题
[玻璃体内 rTPA、气体和雷珠单抗联合治疗新生血管性年龄相关性黄斑变性继发的广泛中心凹下出血]。
DOI：
10.1055/s-0028-1109750
复制
发表时间：
2010
影响因子：
0.8
通讯作者：
U. Schmidt
中科院分区：
文献类型：
--
作者：
G. Matt;S. Sacu;E. Stifter;C. Prünte;U. Schmidt
背景
本研究的目的是评价玻璃体内重组组织纤溶酶原激活剂（rTPA）、气体和Lucentis联合治疗继发于新生血管性年龄相关性黄斑变性（AMD）的广泛黄斑下出血患者的临床结局。
方法
在这项回顾性临床研究中，纳入了10只继发于新生血管性AMD的大面积中心凹下出血的患眼，并在视网膜下出血发作后两周内接受玻璃体内rTPA（0.05 mL; 0.025 mg/0.1 mL，溶于0.9% NaCl）、100%六氟化硫（SF（6））气体（0.5 mL）和lucentis（0.05 mL，10 mg/mL）治疗。如果存在持续性黄斑下出血或活动性脉络膜新生血管（CNV）体征，则每隔4周进行一次Lucentis再治疗。采用最佳矫正视力（VA，Snellen）、完整的眼科检查、荧光素血管造影（弗拉）和光学相干断层扫描（OCT）评价治疗效果。
结果
平均观察期为6.4 A+/- 3.7个月（范围：3 - 13个月）。关于VA，7只眼VA增加（>或= 1 Snellen线），1只眼稳定，2只眼VA降低（>或= 1 Snellen线）。随访结束时，与基线相比，未观察到VA存在显著差异（p = 0.41）。在1例患者中，在初始联合治疗后观察到术中一过性中央动脉闭塞，在另1例患者中观察到角膜糜烂和眼内压升高至27 mmHg。初次治疗后平均有1.9例A+/- 1.3例再次治疗。
结论
rTPA、气体和Lucentis的组合是继发于新生血管性AMD的广泛中心凹下出血的有价值的疗法，可稳定VA和形态学参数。
BACKGROUND
The aim of this study was to evaluate the clinical outcomes of the combination therapy with intravitreal recombinant tissue plasminogen activator (rTPA), gas and lucentis for patients with extensive subfoveal haemorrhages secondary to neovascular age-related macular degeneration (AMD).
METHODS
In this retrospective clinical study 10 eyes with extensive subfoveal haemorrhages secondary to neovascular AMD were included and treated with intravitreal rTPA (0.05 mL; 0.025 mg/0.1 mL in 0.9% NaCl), 100% sulphur hexafluoride (SF(6)) gas (0.5 mL) and lucentis (0.05 mL, 10 mg/mL) within two weeks after the onset of the subretinal haemorrhage. Retreatments with lucentis were performed at 4-week intervals if there were persistent submacular haemorrhages or signs of active choroideal neovascularisation (CNV). The treatment effect was evaluated using best-corrected visual acuity (VA, Snellen), complete ophthalmic examination, fluorescein angiography (FLA) and optical coherence tomography (OCT).
RESULTS
Mean observation period was 6.4 A+/- 3.7 months (range: 3 - 13 months). With regard to VA, in 7 eyes there was an increase in VA (> or = 1 Snellen lines), in 1 eye a stabilisation and in 2 eyes a decrease in VA (> or = 1 Snellen lines). At the end of follow-up time, with regard to VA no significant difference was observed compared to baseline (p = 0.41). In 1 patient an intra-operative transient central arterial occlusion and in another patient a corneal erosion and an increase of intraocular pressure up to 27 mmHg were observed after initial combination treatment. On average there were 1.9 A+/- 1.3 retreatments indicated after initial treatment.
CONCLUSION
The combination of rTPA, gas and lucentis is a valuable therapy for extensive subfoveal haemorrhages secondary to neovascular AMD resulting in stabilisation of both VA and morphologic parameters.