Two-year results of combined intravitreal ranibizumab and photodynamic therapy for retinal angiomatous proliferation
Two-year results of combined intravitreal ranibizumab and photodynamic therapy for retinal angiomatous proliferation
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DOI：
10.1007/s10384-015-0417-x
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发表时间：
2016-01-01
影响因子：
2.4
通讯作者：
Itagaki, Kanako
中科院分区：
文献类型：
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作者：
Saito, Masaaki;Iida, Tomohiro;Itagaki, Kanako
目的本研究旨在阐明玻璃体内注射雷尼单抗（IVR）和光动力治疗（PDT）联合治疗症状性视网膜血管瘤性增生（RAP）患者超过24个月的疗效。方法回顾性分析31例37只裸眼，连续3个月进行IVR注射（0.5 mg/0.05 ml）和PDT治疗，随访至少24个月。结果最佳矫正视力水平最小分辨角的平均对数由基线时的0.63提高到24个月时的0.39，差异有统计学意义（P < 0.0001）。9只（24%）眼睛出现了涉及中央凹的地理萎缩（GA）， 24个月时VA显著（P = 0.036）下降，基线时网状假性结节（RPD）的发生率很高（100%）。视网膜-视网膜吻合处35眼完全闭塞，33眼24月完全闭塞。24个月时，视网膜中央厚度由415 μ m下降至129 μ m，差异有统计学意义（P < 0.0001）。24个月的平均治疗次数为2.5次PDT和5.5次IVR注射。结论IVR注射和PDT联合治疗对于维持或改善RAP患者2年内的VA和视网膜形态是普遍有效的，但基线RPD患者可能在中央凹发生GA，导致VA降低。
Purpose The aim of this study was clarify the efficacy of combination therapy of intravitreal ranibizumab (IVR) injections and photodynamic therapy (PDT) in patients with symptomatic retinal angiomatous proliferation (RAP) over 24 months.Methods We retrospectively reviewed 37 naive eyes of 31 patients treated with three consecutive monthly IVR injections (0.5 mg/0.05 ml) and PDT and followed for at least 24 months.Results The mean logarithm of the minimum angle of resolution best-corrected visual acuity levels improved significantly (P < 0.0001) from 0.63 at baseline to 0.39 at 24 months. Geographic atrophy (GA) involving the fovea developed in nine (24 %) eyes, with a significant (P = 0.036) decrease in VA at 24 months and a high (100 %) prevalence of reticular pseudodrusen (RPD) at baseline. Complete occlusion of the retinal-retinal anastomosis seen in 35 eyes was achieved in 33 eyes at month 24. The central retinal thickness decreased significantly (P < 0.0001) from 415 to 129 mu m at 24 months. The mean number of treatments during 24 months was 2.5 PDT and 5.5 IVR injections.Conclusions Combination therapy comprising IVR injections and PDT is generally effective in maintaining or improving VA and retinal morphology within 2 years in eyes with RAP, except for eyes with baseline RPD, which are likely to develop GA in the fovea resulting in reduced VA.