雷珠单抗治疗Ⅰ型和Ⅱ型特发性脉络膜新生血管病变的疗效

Clinical efficacy of intravitreal Ranibizumab in idiopathic choroid neovascularization type Ⅰ and type Ⅱ

目的:探讨雷珠单抗(ranibizumab)治疗特发性脉络膜新生血管(idiopathic choroidal neovascularization,ICNV)的有效性,分析在光学相干断层扫描(optical coherence tomography,OCT)下不同形态表现的特发性脉络膜新生血管(Ⅰ型和Ⅱ型)的疗效差异,进一步为雷珠单抗在治疗脉络膜新生血管的有效性提供依据,指导临床治疗。方法:对我院2013-10/2014-06的31例(Ⅰ型9例,Ⅱ型22例)诊断为"ICNV"并接受玻璃体腔注射雷珠单抗的患者资料进行回顾性分析,比较分析最佳矫正视力(bestcorrected visual acuity,BCVA)和OCT测量病灶处视网膜最大厚度的变化趋势有无不同。结果:患者31例(其中Ⅰ型9例,Ⅱ型22例)经统计学分析,在术前与术后1,3mo BCVA和病灶视网膜最大厚度的比较具有统计学意义,不同ICNV类型患者治疗前后的最佳矫正视力及病灶处视网膜最大厚度的变化趋势的差异无统计学意义,说明雷珠单抗玻璃体腔注射对于治疗特发性脉络膜新生血管疗效肯定,对于Ⅰ型和Ⅱ型ICNV的临床治疗效果不具显著性差异。结论:玻璃体腔注射雷珠单抗治疗特发性脉络膜新生血管疗效肯定,对于Ⅰ型和Ⅱ型ICNV本组研究中尚未发现存在疗效差异。其安全性和远期并发症需进一步研究证实。

AIM ： To evaluate the efficacy of intravitreal ranibizum ab in idiopathic choroid neovascularization（ ICNV）,compare the difference of the curative effect between type Ⅰ and Ⅱ of ICNV by optical coherence tomography（ OCT）,further provide evidence of the to effectiveness of ranibizum ab in the treatment of choroidal neovascularization to guide clinical treatment.METHODS： A retrospective analysis on the clinical data who were diagnosed as ICNV between October 2013 and June 2014 in our hospital were carried out. Totally 31cases（ 9 cases of type Ⅰ and 22 cases of type Ⅱ）accepted ranibizum ab injection voluntarily. All of the patients were evaluated by ophthalmic examination,funduscopy and OCT before and after the injection,classificated according to OCT results. The best-corrected visual acuity（ BCVA） and mximum of edema thickness after ranibizum ab treatment at 3mo follow- up were com pared. RESULTS： After statistically analyzed, BCVA and maximum thickness of the retinal lesions of 31 patients（ type Ⅰ9 cases,type Ⅱ 22 cases） before and 1,3mo after treatment had statistical significance. In different types of retinal ICNV patients, BCVA and maximum thickness of the retinallesions before and after treatment had no statistical significance. It was said that ranibizum ab intravitreal injection had effectiveness for ICNV,how ever,there w ere no significant effectiveness for typeⅠ andⅡ ICNV. CONCLUSION： Ranibizumab intravitreal injection has obvious effectiveness for ICNV. However,it has no effect on type Ⅰ and Ⅱ ICNV. Its safety and long- term complications need for further study.