摘要
目的研究雷珠单抗(IVR)联合光动力疗法(PDT)对湿性年龄相关性黄斑变性(w AMD)患者眼压、视力的疗效和对血清血管内皮生长因子(VEGF)、转换生长因子-β1(TGF-β1)的影响。方法选取2015年3月—2017年3月我院眼科收治的w AMD患者60例,共71只患眼,治疗方法分为观察组30例(36只),对照组30例(35只)患眼。对照组给予玻璃体内注射雷珠单抗,观察组在对照组基础上给予PDT。随访6个月,比较2组重复治疗次数、不良反应和并发症发生率;观察并记录2组眼压、视力、中心凹视网膜厚度(CRT)和脉络膜新生血管(CNV)渗漏情况;检测并比较2组VEGF与TGF-β1浓度。结果治疗后6个月,观察组IVR重复治疗次数低于对照组(P <0. 05); 2组并发症、不良反应发生率和眼压比较无统计学意义(P> 0. 05)。治疗后1、3、6个月,2组最佳矫正视力均呈上升趋势,且观察组高于对照组(P <0. 05),CRT均呈降低趋势,且观察组低于对照组(P <0. 05)。治疗后3个月,2组CNV比较差异无统计学意义(P> 0. 05);治疗后6个月,观察组CNV闭合率高于对照组,复发率低于对照组(P <0. 05)。治疗3个月后,2组VEGF及TGF-β1浓度均低于治疗前,且观察低于对照组(P <0. 05)。结论雷珠单抗联合PDT治疗可有效提高w AMD患者视力,降低CNV复发率,治疗效果良好且安全性高。
Objective To explore Effectiveness and effects of intravitreal injection of Ranibizumab(IVR)combined with photodynamic therapy(PDT)on intraocular pressure,visual acuity,serum vascular endothelial growth factor(VEGF)and transforming growth factor-β1(TGF-β1)in treatment of patients with wet-type age-related macular degeneration(wAMD).Methods A total of 60 wAMD patients(71 affected eyes)admitted during March 2015 and March 2017 were divided into observation groups(n=30,36 affected eyes)and control group(n=30,35 affected eyes)according to therapeutic methods.Control group was treated with IVR,while observation group was added with PDT on the basis of treatment for control group.During 6 months of follow-up in two groups,repeated treatment frequency and incidence rates of adverse reaction and complications were compared;conditions of intraocular pressure,visual acuity,central retinal thickness(CRT)and the leakage of choroidal neovascularization(CNV)were observed and compared;concentrations of vascular endothelial growth factor(VEGF)and transforming growth factor-β1(TGF-β1)were detected and compared.Results After 6 months of treatment,frequency of repeated IVR treatment in observation group was significantly lower than that in control group(P<0.05),and there were no significant differences in incidence rates of complications and adverse reaction and intraocular pressure between the groups(P >0.05).After 1 month,3 months and 6 months of treatment,the best corrected visual acuity showed ascending trend in two groups,and the values in observation group were significantly higher than those in control group(P<0.05);CRT values showed a decreasing trend in two groups,and the values in observation group were significantly lower than those in control group(P<0.05).After 3 months of treatment,there was no significant difference in CNV leakage between two groups(P >0.05).After 6 months of treatment,in observation group,CNV closure rate was significantly higher,while recurrence rate was significantly lower than those in control group(P<0.05).After 3 months of treatment,concentrations of VEGF and TGF-β1 were significantly decreased compared with those before treatment in two groups,and the concentrations in observation group were significantly lower than those in control group(P<0.05).Conclusion Ranibizumab combined with PDT in treatment of patients with wet-type age-related macular degeneration may effectively improve visual acuity and reduce recurrence rate of CNV with good effectiveness and safety.
作者
周佳子
姜艳华
ZHOU Jia-zi;JIANG Yan-hua(Department of Ophtalmology,the Fourth People' s Hospital of Shenyang,Shenyang 110000,China)
出处
《解放军医药杂志》
CAS
2019年第2期102-106,共5页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
辽宁省自然科学基金计划重点项目(20170520009)
关键词
黄斑变性
雷珠单抗
光化学疗法
血管内皮生长因子
Macular degeneration
Ranibizumab
Photochemotherapy
Vascular endothelial growth factor