Intravitreal Injection of Ranibizumab for Recovery of Macular Function in Eyes With Subfoveal Polypoidal Choroidal Vasculopathy
Intravitreal Injection of Ranibizumab for Recovery of Macular Function in Eyes With Subfoveal Polypoidal Choroidal Vasculopathy
复制标题
DOI：
10.1167/iovs.12-11494
复制
发表时间：
2013-05-01
影响因子：
4.4
通讯作者：
Yoshimura, Nagahisa
中科院分区：
文献类型：
--
作者：
Ogino, Ken;Tsujikawa, Akitaka;Yoshimura, Nagahisa
目的.评价玻璃体内雷珠单抗（IVR）治疗后息肉状脉络膜血管病变（PCV）患者黄斑功能的变化。来自23名未经治疗的中心凹下PCV患者的23只眼睛接受了三次每月一次的IVR注射，然后按需注射。视力（VA）;在治疗开始前和治疗3个月和12个月后评估视网膜厚度（用光学相干断层扫描测量）、黄斑敏感度（用微视野测量）和焦点黄斑视网膜电图（fmERG）。治疗前黄斑囊样水肿5眼，浆液性视网膜脱离13眼，浆液性色素上皮脱离18眼。IVR治疗导致了实质性的形态学改善和随之而来的中央凹厚度的显着减少（P = 0.008）。虽然在12个月的研究期间，最小分辨角（logMAR）VA的对数没有显著改善（P = 0.623），但在3个月时，fmERG明视负反应的幅度和4度以内的黄斑敏感度显著增加（分别为P = 0.004，P = 0.026）。这一趋势一直持续到12个月监测期结束。在先前存在浆液性视网膜脱离的眼中，那些在3个月时脱离完全消退的眼睛也表现出fmERG a波振幅的更大增加（P = 0.048）。IVR治疗导致黄斑中心凹下PCV患者的形态学改善和黄斑功能部分恢复。这种治疗可以通过解决浆液性视网膜脱离来改善感光功能。
PURPOSE. To evaluate changes in macular function in eyes with polypoidal choroidal vasculopathy (PCV) after intravitreal ranibizumab (IVR) treatment.METHODS. Twenty-three eyes from 23 patients with treatment-naive subfoveal PCV received three monthly injections of IVR, followed by as-needed injections. Visual acuity (VA); retinal thickness (measured with optical coherence tomography); macular sensitivity (measured with microperimetry); and focal macular electroretinograms (fmERGs) were evaluated both before the initiation of therapy and after 3 and 12 months.RESULTS. Before treatment, cystoid macular edema was observed in five eyes, serous retinal detachments in 13 eyes, and serosanguinous pigment epithelial detachments in 18 eyes. IVR treatment resulted in substantial morphological improvements and consequent marked reductions in foveal thickness (P = 0.008). Although logarithm of the minimum angle of resolution (logMAR) VA did not improve significantly over the 12-month study period (P = 0.623), the amplitude of the fmERG photopic negative response and macular sensitivity within 4 degrees had increased significantly at 3 months (P = 0.004, P = 0.026, respectively). This trend persisted until the end of the 12-month monitoring period. Among the eyes with preexisting serous retinal detachments, those in which the detachments had resolved completely at 3 months also exhibited greater increases in fmERG a-wave amplitudes (P = 0.048).CONCLUSIONS. IVR therapy resulted in morphological improvements and the partial recovery of macular function in eyes with subfoveal PCV. This therapy may improve photoreceptor function by resolving serous retinal detachments.