Intravitreal Ranibizumab Injection as an Adjuvant in the Treatment of Neovascular Glaucoma Accompanied by Vitreous Hemorrhage after Diabetic Vitrectomy.
Intravitreal Ranibizumab Injection as an Adjuvant in the Treatment of Neovascular Glaucoma Accompanied by Vitreous Hemorrhage after Diabetic Vitrectomy.
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DOI：
10.1155/2016/4108490
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发表时间：
2016
影响因子：
1.9
通讯作者：
Zhong Y
中科院分区：
文献类型：
--
作者：
Shen X;Chen Y;Wang Y;Yang L;Zhong Y
目的.探讨玻璃体内注射雷珠单抗作为辅助治疗伴有玻璃体切除术后糖尿病玻璃体出血（PDVH）的新生血管性青光眼（NVG）的疗效。方法.本前瞻性、单中心、12个月、干预性病例系列研究入组了18例伴有PDVH的NVG患者（18只眼）。连续18例IOP ≥ 25 mmHg的患者，尽管接受了最大限度的药物治疗，但仍接受了玻璃体内注射雷珠单抗治疗。如果玻璃体出血和不受控制的IOP没有显示临床改善，则需要进行玻璃体手术或/联合Ahmed瓣膜植入。结果10例患者仅注射2.7 ± 1.8次雷珠单抗即可获得透明玻璃体和控制的IOP，无需额外手术。其余8眼因眼压和眼压控制不佳行玻璃体切除术或/和Ahmed阀植入术。术后随访12个月，18眼玻璃体均透明。第12个月时，BCVA与基线相比显著改善。基线和第12个月随访时IOP/药物使用分别为36.7 ± 8.1 mmHg（3.4 ± 0.7种药物）和16.2 ± 4.9 mmHg（0.67 ± 0.77种药物）。结论.结果表明，玻璃体内注射雷珠单抗作为辅助治疗NVG伴PDVH可能是安全和有效的。本临床试验注册号为NCT 02647515。
Purpose. To determine the efficacy of intravitreal ranibizumab injection as adjuvant therapy in the treatment of neovascular glaucoma (NVG) accompanied by postvitrectomy diabetic vitreous hemorrhage (PDVH). Methods. Eighteen NVG patients (18 eyes) accompanied by PDVH were enrolled in this prospective, monocenter, 12-month, interventional case series. The consecutive 18 patients with an IOP ≥ 25 mmHg despite being treated with the maximum medical therapy were treated with intravitreal ranibizumab injections. Vitreous surgery or/with Ahmed valve implantation were indicated if no clinical improvement in vitreous haemorrhage and uncontrolled IOP was shown. Results. Ten patients got clear vitreous and controlled IOP only with 2.7 ± 1.8 injections of ranibizumab without additional surgery. Vitrectomy or/with Ahmed valve implantation was administered in the other 8 eyes due to uncontrolled VH and IOP. At follow-up month 12, all the 18 eyes gained clear vitreous. At month 12 BCVA improved significantly compared to baseline. The baseline and follow-up at month 12 IOP/medication usage were 36.7 ± 8.1 mmHg on 3.4 ± 0.7 medications and 16.2 ± 4.9 mmHg on 0.67 ± 0.77 medications, respectively. Conclusions. The findings suggest that intravitreal ranibizumab injection as adjuvant therapy for treatment of NVG accompanied by PDVH may be safe and potentially effective. This clinical trial is registered with NCT02647515.