雷珠单克隆抗体治疗湿性年龄相关性黄斑变性的临床疗效分析

Clinical efficacy analysis of ranibizumab for wet age-related macular degeneration

目的分析玻璃体腔注射雷珠单克隆抗体治疗湿性年龄相关性黄斑变(AMD)的临床有效性和安全性。方法回顾性研究。临床检查确诊的湿性AMD患者23例(26只眼),前3个月,每个月予以玻璃体腔内注射雷珠单克隆抗体0.5mg,随访3个月,对比分析患者治疗前及治疗后1、2、3个月的最佳矫正视力(BCVA)、中央视网膜厚度(CRT)及新生血管病灶面积变化情况以及不良反应。采用秩和检验对BCVA、CRT和脉络膜新生血管(CNV)病灶面积数据进行统计学分析。结果雷珠单克隆抗体注射治疗次数为3次。26只眼治疗后末次随访检查时,BCVA较治疗前提高,差异有统计学意义(P<0.001)。CRT与治疗前比较均下降,差异有统计学意义(P<0.001)。CNV病灶面积较治疗前均缩小,差异有统计学意义(P<0.001)。结论玻璃体腔注射雷珠单克隆抗体治疗湿性AMD是安全有效的,可提高患眼视力,使视网膜厚度降低,抑制新生血管。

Objective To analyze the clinical efficacy and safety of intravitreal injection of ranibizumab in the treatment of wet age-related macular degeneration (w-AMD).Methods This study was a retrospective case study.Twenty-three patients (26 eyes) with w-AMD diagnosed by clinical examination were treated with intravitreal injection of ranibizumab (0.5 mg) every month for the first three months.The patients were followed up for another three months.The best corrected visual acuity (BCVA), central retinal thickness (CRT including inner thickness and full thickness),neovascularization area (outer retinal,choriocapillaris) and surgical complications were compared and analyzed before the treatment,and at 1,2 and 3 months after the treatment using rank sum test.Results The number of ranibizumab injections was 3 times.At the last follow-up examination of the 26 eyes after the treatment,BCVA was significantly better than that before the treatment ( P <0.001).CRT was significantly lower than that before the treatment ( P <0.001).The area of CNV was significantly smaller than that before the treatment ( P <0.001).Conclusions Intravitreal injection of ranibizumab is safe and effective in the treatment of wet age-related macular degeneration,with significant improvement in the visual acuity, retinal thickness and neovascularization.