Effects of Ranibizumab in Patients with Subfoveal Choroidal Neovascularization Attributable to Age-related Macular Degeneration
Effects of Ranibizumab in Patients with Subfoveal Choroidal Neovascularization Attributable to Age-related Macular Degeneration
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DOI：
10.1016/j.ajo.2008.12.005
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发表时间：
2009-05-01
影响因子：
4.2
通讯作者：
Wolf-Schnurrbusch, Ute E. K.
中科院分区：
文献类型：
--
作者：
Rothenbuehler, Simon P.;Waeber, David;Wolf-Schnurrbusch, Ute E. K.
目的：证明在年龄相关性黄斑变性（AMD）患者接受可变剂量方案的雷尼单抗治疗24个月后，不仅可以预防视力丧失，还可以改善最佳矫正视力（BCVA）。设计：介入性病例系列。方法：环境：机构。研究人群：138例患者中的138只眼睛接受0.5 mg雷尼单抗（Lucentis; Novartis, Basel, Switzerland）玻璃体内治疗。年龄大于50岁，BCVA最小分辨角（logMAR）的0.2 - 1.2对数，继发于AMD的原发性或复发性中央凹下脉络膜新生血管（CNV）。观察方法：单次初始治疗后，每月随访检查。出现以下情况之一时再次治疗：视网膜下积液或视网膜内水肿，光学相干断层扫描（OCT）视网膜中央厚度（CRT）增加，荧光素血管造影CNV活性增加，变形增加，早期治疗糖尿病视网膜病变研究（ETDRS）图上BCVA bbb50字母丢失。主要结局指标：与基线比较：获得15个字母的眼睛比例，失去或获得< 15个字母的眼睛比例，crt的变化。24个月后，30%的眼睛增加了>= 15个字母。24个月后，55%的眼睛减少或增加了< 15个字母。基线时的平均CRT为386 +/- 145 μ m， 24个月后显著降低至211 +/- 39 μ m （P = 0.036）。从基线到12个月和12至24个月，每位患者的平均注射次数分别为5.6 +/- 2.9和4.3 +/- 3.8。结论：可变剂量方案的玻璃体内雷尼单抗可显著提高平均BVCA和降低CRT。在我们的患者中，这一有益的结果是在轻度眼部不良反应发生率低的情况下实现的。[J]中华眼科杂志，2009;47:831-837。(c) 2009年Elsevier Inc.版权所有。)
PURPOSE: To demonstrate not only prevention of vision loss but also improvement in best-corrected visual acuity (BCVA) after treatment with ranibizumab on a variable-dosing regimen over 24 months in patients with age-related macular degeneration (AMD).DESIGN: Interventional case series.METHODS: SETTING: Institutional. STUDY POPULATION: One hundred and thirty-eight eyes of 138 patients treated intravitreally with 0.5 mg ranibizumab (Lucentis; Novartis, Basel, Switzerland). Age above 50 years, BCVA 0.2 to 1.2 logarithm of the minimal angle of resolution (logMAR), primary or recurrent subfoveal choroidal neovascularization (CNV) secondary to AMD. OBSERVATION PROCEDURES: After single initial treatment, Monthly follow-up examination. Retreatment in case of one of the following: sign of subretinal fluid or intraretinal edema, increase in central retinal thickness (CRT) on optical coherence tomography (OCT), active CNV on fluorescein angiography, increase of metamorphopsia, and loss of BCVA >5 letters on Early Treatment Diabetic Retinopathy Study (ETDRS) chart. MAIN OUT-COME MEASURES: Compared with baseline: proportion of eyes gaining 15 letters, proportion of eyes losing or gaining < 15 letters, change in CRT.RESULTS. After 24 months, 30% of eyes gained >= 15 letters. After 24 months, 55% of eyes lost or gained < 15 letters. Mean CRT of 386 +/- 145 mu m at baseline was significantly reduced to 211 +/- 39 mu m after 24 months (P = .036). Mean injection number per patient was 5.6 +/- 2.9 and 4.3 +/- 3.8 from baseline to month 12 and month 12 to 24, respectively.CONCLUSION: Intravitreal ranibizumab on a variable-dosing regimen was effective in significantly increasing mean BVCA and reducing CRT. This beneficial outcome was achieved with a low-rate of mild ocular adverse effects among our patients. (Am J Ophthalmol 2009;147: 831-837. (c) 2009 by Elsevier Inc. All rights reserved.)