Ranibizumab as adjuvant in the treatment of rubeosis iridis and neovascular glaucoma-results from a prospective interventional case series
Ranibizumab as adjuvant in the treatment of rubeosis iridis and neovascular glaucoma-results from a prospective interventional case series
复制标题
DOI：
10.1007/s00417-013-2428-y
复制
发表时间：
2013-10-01
影响因子：
2.7
通讯作者：
Grisanti, Salvatore
中科院分区：
文献类型：
--
作者：
Lueke, Julia;Nassar, Khaled;Grisanti, Salvatore
为了评价辅助眼内注射雷珠单抗（LucentisA（R））治疗红斑和新生血管性青光眼患者的红斑和眼内压的能力，在这个前瞻性、单中心、12个月的干预性病例系列中，10只红斑（R）眼和10只新生血管性青光眼（NVG）眼接受了LucentisA（R）注射（雷珠单抗0.5 mg/0.05 ml）。主要疗效结局指标为12个月后通过虹膜荧光素血管造影术测量的虹膜发红程度变化。次要结果是眼内压（IOP）、最佳矫正视力（BCVA，logMAR）、注射后额外干预或抗青光眼药物的数量、前房角的房角镜检查状态和中央视网膜厚度。其他治疗包括光凝（n = 19）、睫状体破坏性手术（n = 9）、冷冻固定术（n = 3）和玻璃体切除术（n = 1）。基线时，R组和NVG组的红变平均分期分别为3.4 A +/- 0.7和3.6 A +/- 0.8。在第12个月，R组的红斑几乎消退（0.1 A +/- 0.3，p < 0.001），NVG组的红斑显著减少（0.7 A +/- 1.1，p < 0.001）。在NVG亚组中，基线时平均IOP为41.4 A +/- 13.4 mmHg，迅速下降（18.2 A +/- 12.3，第-14天，p = 0.005），并在随访期间稳定（15.6 A +/- 2.0 mmHg，p < 0.05）。两组的BCVA均显著改善（p < 0.05，在第12个月）。注射0.5 mg雷珠单抗作为新生血管性青光眼和红斑的辅助治疗似乎是有益的，因为其抗血管生成特性和其防止前房角阻塞的建立或进展的能力。在分阶段治疗方法中仍然需要解决视网膜缺血的常规治疗程序。
To evaluate the capability of adjuvant intraocular ranibizumab (LucentisA (R)) injections in the treatment of rubeosis and intraocular pressure in patients with rubeosis and neovascular glaucoma.Ten eyes with rubeosis (R) and ten eyes with neovascular glaucoma (NVG) received LucentisA (R) injections (ranibizumab 0.5 mg/0.05 ml) in this prospective, monocenter, 12-months, interventional case series. The primary efficacy outcome measure was the change of degree of iris rubeosis as documented by iris fluorescein angiography measured after 12 months. Secondary outcomes were intraocular pressure (IOP), best-corrected visual acuity (BCVA, logMAR), numbers of additional interventions or antiglaucoma medications administered after injection, the gonioscopic status of the anterior chamber angle, and central retinal thickness.In the R group, 3.6 injections and in the NVG group 2.3 injections of LucentisA (R) were administered. Additional treatments were photocoagulation (n = 19), cyclodestructive procedures (n = 9), cryopexy (n = 3), and vitrectomy (n = 1). The mean stage of rubeosis was 3.4 A +/- 0.7 in the R group and 3.6 A +/- 0.8 in the NVG group at baseline. At month 12, the rubeosis was almost resolved in the R group (0.1 A +/- 0.3, p < 0.001), and decreased significantly in the NVG group (0.7 A +/- 1.1, p < 0.001). In the NVG subgroup, mean IOP was 41.4 A +/- 13.4 mmHg at baseline, which decreased rapidly (18.2 A +/- 12.3, day-14, p = 0.005) and stabilized during the follow-up (15.6 A +/- 2.0 mmHg, p < 0.05). BCVA improved significantly in both groups (p < 0.05, at month 12).Injection of 0.5 mg ranibizumab appears to be beneficial as an adjuvant treatment in neovascular glaucoma and rubeosis due to its anti-angiogenic properties and its ability to prevent establishment or progression of anterior chamber angle obstruction. Conventional therapeutic procedures addressing the retinal ischemia are still required in a stage-wise treatment approach.