雷珠单抗治疗黄斑区脉络膜新生血管的疗效观察

The efficacy of ranibizumab treatment in patients with macular choroidal neovascularization

目的观察玻璃体腔注射雷珠单抗治疗黄斑区脉络膜新生血管(choroidal neovascularization,CNV)的疗效及安全性。方法对26例26眼经光学相干断层扫描(optical coherence tomography,OCT)及眼底血管荧光造影(fundus fluoresceine angiography,FFA)确诊为黄斑区CNV(包括年龄相关性黄斑变性、高度近视性黄斑病变以及中心性渗出性脉络膜视网膜病变)的患者进行玻璃体腔内注射0.5 mg/0.05 ml雷珠单抗,随访3个月,观察患者最佳矫正视力(best-corrected visual acuity,BCVA)、黄斑区结构改变及不良反应。在随访期间,经OCT检查发现黄斑区神经上皮层仍有层间积液或视网膜下液、CNV未见明显缩小、FFA检查发现仍有荧光素渗漏者需行再次注射雷珠单抗。结果所有患者第一次治疗前BCVA(ETDRS字母表)的平均字母数为(17.65±13.96)个,3个月后的平均字母数为(34.23±16.36)个,3个月后与第一次治疗前的视力差异具有统计学意义(P<0.05)。所有患者第一次治疗前黄斑中心凹厚度(central macular thickness,CMT)为(310.84±113.13)μm,随访第3个月时为(198.76±46.90)μm,前后相比差异具有统计学意义(P<0.05)。术中、术后及随访期间未见眼部及全身不良反应。结论玻璃体腔内注射雷珠单抗治疗黄斑区CNV安全有效。

Objective To evaluate the efficacy and safety of intravitreal injection of ranibizumab for macular choroidal neovascularization（CNV）. Methods Twenty-six eyes of 26 patients diagnosed with macular choroidal neovascularization caused by age-related macular degeneration, high myopia macular degeneration and central exudative retinopathy were included in this study. Intravitreal injections of ranibizumab（0. 5 mg/0.5 ml） were performed on all eyes. All patients were followed-up for 3 months, and the best-corrected visual acuity（ BCVA）, the central macular thickness（CMT） and complications were recorded. Results During the follow-up period, the mean of BCVA improved from （ 17.65± 13.96） letters to （34. 23±16. 36） letters after a follow-up of 3 months （P 〈 0.05 ） ; the mean of C MT decreased from （310. 84±113.13 ）μm to （198.76± 46.90 ） μm after a follow-up of 3 months （P 〈 0. 05 ）. Retinal detachment, endophthalmitis, lens injury and systemic adverse reactions were not found. Conclusion Intravitreal injection of ranibizmnab is an effective and safe treatment for macular CNV.