Intravitreal ranibizumab (LucentisA®) for the treatment of myopic choroidal neovascularization
Intravitreal ranibizumab (LucentisA®) for the treatment of myopic choroidal neovascularization
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DOI：
10.1007/s00417-008-0995-0
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发表时间：
2009-03-01
影响因子：
2.7
通讯作者：
Ambresin, Aude
中科院分区：
文献类型：
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作者：
Konstantinidis, Lazaros;Mantel, Irmela;Ambresin, Aude
黄斑脉络膜新生血管（CNV）是近视眼最严重的视力威胁并发症之一，可导致严重的视力丧失。本研究的目的是评估玻璃体内注射雷珠单抗治疗近视CNV的安全性和有效性。我们对2006年6月至2008年2月在朱尔斯高宁大学眼科医院接受雷珠单抗玻璃体内注射治疗的继发于病理性近视（PM）的中心凹下或中心凹旁CNV患者进行了一项前瞻性、连续性、干预性研究。在基线和每月对所有患者进行最佳矫正视力（BCVA）、光学相干断层扫描（OCT）和荧光素血管造影（FA）。再次治疗的指征是与FA显示的CNV持续渗漏和/或OCT显示的CNV活动证据相关的BCVA丧失。平均等效球镜屈光不正为-12.5（范围，-8.0 D至-16.0 D）。平均随访时间为8.4个月（范围3至16个月，SD：3）。每例患者玻璃体内注射的平均次数为2.36（SD 1.5）。平均初始视力（VA）为0.19小数当量（logMAR：0.71，SD：0.3）。在最终随访时，证实了统计学显著改善，平均VA为0.48小数当量（log-MAR：0.32，SD：0.25）。VA平均改善3.86（SD 2.74）行。9例患者（64%）表现出3行或更多行的增益。OCT测量的平均中心黄斑厚度（CMT）在基线时为304 μ m（SD：39），在最终随访时显著降低至153 μ m（SD：23）。平均CMT减少170 μ m（SD：57）。随访期间未发现注射并发症或药物相关的副作用。在随访时间有限的这一小部分患者中，玻璃体内注射雷珠单抗是继发于PM的CNV的安全有效的治疗方法，可改善功能和解剖结构。
Macular choroidal neovascularization (CNV) is one of the most vision-threatening complications of myopia, which can lead to severe vision loss. The purpose of this study was to evaluate the safety and efficacy of intravitreal ranibizumab in the treatment of myopic CNV.We conducted a prospective, consecutive, interventional study of patients with subfoveal or juxtafoveal CNV secondary to pathologic myopia (PM) treated with intravitreal injection of ranibizumab in the Jules Gonin University Eye Hospital from June 2006 to February 2008. Best-corrected visual acuity (BCVA), optical coherence tomography (OCT), and fluorescein angiography (FA) were performed at baseline and monthly for all patients. Indications for retreatment were loss in BCVA associated either with persistent leakage from CNV shown on FA, and/or evidence of CNV activity on OCT.The study included 14 eyes of 14 patients. The mean spherical equivalent refractive error was -12.5 (range, -8.0 D to -16.0 D). Mean time of follow-up was 8.4 months (range from 3 to 16 months, SD: 3). The mean number of intravitreal injections administered for each patient was 2.36 (SD 1.5). The mean initial visual acuity (VA) was 0.19 decimal equivalent (logMAR: 0.71, SD: 0.3). A statistically significant improvement to a mean VA of 0.48 decimal equivalent (log-MAR:0.32, SD: 0.25) was demonstrated at the final follow-up. VA improved by a mean of 3.86 (SD 2.74) lines. Nine patients (64%) demonstrated a gain of 3 or more lines. Mean central macular thickness (CMT) measured with OCT was 304 mu m (SD: 39) at the baseline, and was reduced significantly at the final follow-up to 153 mu m (SD: 23). Average CMT reduction was 170 mu m (SD: 57). No injection complications or drug-related side effects were noted during the follow-up period.In this small series of eyes with limited follow-up, intravitreal ranibizumab was a safe and effective treatment for CNV secondary to PM, resulting in functional and anatomic improvements.