玻璃体内注射雷珠单抗治疗特发性脉络膜新生血管疗效观察

Intravitreal injection of ranibizumab for idiopathic choroidal neovascularization

目的观察雷珠单抗治疗特发性脉络膜新生血管（idiopathic choroidal neovascularization,ICNV）的有效性和安全性。方法采用非随机对照临床回顾性研究,对18例18眼经间接眼底镜、光学相干断层扫描（optical coherence tomograph,OCT）、眼底荧光血管造影（fundus fluorescein angiograph,FFA）检查确诊的ICNV患者,行玻璃体内注射0.5 mg雷珠单抗治疗。术后每个月随访1次,6个月后若病情稳定可改为每2个月随访一次,随访时经OCT、FFA证实病情反复者则眼内重复注射。统计分析治疗期间的最佳矫正视力（best corrected visual acuity,BCVA）、黄斑中心凹视网膜厚度（central retina thickness,CRT）、眼部及全身不良反应。结果 18例18眼患者均完成6~12个月的随访,治疗前患者的BCVA为45.00±1.00,治疗后1周、1个月、3个月、6个月及末次随访时的BCVA分别为55.89±4.23、64.22±9.35、73.00±7.44、76.17±6.62、73.72±5.92,与治疗前比较差异有统计学意义（P〈0.05）。治疗前患者的CRT为（338.44±37.85）μm,治疗后1周、1个月、3个月、6个月及末次随访时的CRT分别是（289.22±32.53）μm、（237.67±32.45）μm、（216.06±25.11）μm、（215.39±20.41）μm、（200.39±15.10）μm,与治疗前比较差异有统计学意义（P〈0.05）。随访过程中未发现全身不良反应及眼部严重并发症。结论玻璃体内注射雷珠单抗能快速有效地提高ICNV患者的BCVA,稳定病情,但必要时需重复注射。

Objective To observe the efficacy and safety of intravitreal injection of ranibizumab in the treatment of idiopathic choroidal neovascularization（ICNV）.Methods An uncontrolled retrospective clinical study.Eighteen eyes of eighteen patients with ICNV diagnosed by indirect ophthalmoscopy,optical coherence tomography（OCT） and fundus fluorescein angiography（FFA） were treated with intravitreal injection of 0.5 mg ranibizumab.Patients were followed up every month after operation,but if they were in a stable condition 6months after operation,they might be followed up every 2 months.If their condition repeatedly manifests after injection diagnosed by optical coherence tomography or fundus fluorescein angiography,they should be injected with ranibizumab again.Best corrected visual acuity（BCVA）,central retinal thickness（CRT）,ocular and systemic adverse reactions were analyzed.Results All patients were followed up for 6 months to 12 months.BCVA of patients before treatment was 45.00 ± 1.00,which at 1 week,1 month,3 months,6 months and the last follow-up after treatment were 55.89 ±4.23,64.22±9.35,73.00±7.44,76.17±6.62,73.72 ±5.92,respectively,there were significant differences（P〈0.05）.CRT of patients before treatment was（338.44 ±37.85） μm,which at 1 week,1 month,3 months,6 months and the last follow-up after treatment were（289.22 ± 32.53） μm,（237.67 ± 32.45） μm,（216.06 ±25.11） μm,（215.39 ±20.41） μm,（200.39 ±15.10） μm,respectively,there were significant differences（P〈0.05）.Ocular and systemic adverse reaction was not found during treatment.Conclusion Intravitreal injection of ranibizumab can quickly and effectively improve BCVA of patients with ICNV with stable condition,but sometimes the repeated injection should be taken.