CAJ | 학술논문

目的观察玻璃体腔注射Ranibizumab(商品名Lucentis)治疗脉络膜新生血管(CNV)的临床疗效及安全性.方法临床病例治疗前后对照研究.对2012年8月至2013年8月在天津市眼科医院经临床检查确诊的30例(30只眼)CNV患者纳入研究.术后随访3～10个月,平均7.2个月.采用国际标准视力表行最佳矫正视力(BCVA)和光学相干断层扫描(OCT)检查黄斑中心视网膜厚度(CRT).为便于统计分析,视力换算成最小分辨角对数视力(logMAR).采用玻璃体腔注射10mg/ml的Ranibizumab0.05ml(含Ranibizumab0.5mg),治疗后1个月如发现CNV病灶扩大或新发病灶行再次注射治疗.采用配对t检验对比分析治疗前后视力、CRT的变化.结果治疗后1个月,平均CRT为(290.23±79.16)μm,矫正视力平均为(0.62±0.31) logMAR,分别与治疗前比较,差异均有统计学意义(t=6.11、4.79,P＜0.05).治疗后3个月,平均CRT为(319.73±89.05) μm,矫正视力平均为(0.61±0.34) logMAR,与治疗前相比,差异均有统计学意义(t=7.69、5.16,P＜0.05).首次治疗后1个月CRT下降幅度最大.随访中未发现眼内感染等与玻璃体腔注射相关的并发症.结论玻璃体腔注射Ranibizumab治疗CNV安全有效,可以提高患者视力.OCT可通过CRT值变化初步指导治疗,便于临床观察.
목적 관찰파리체강주사Ranibizumab(상품명Lucentis)치료맥락막신생혈관(CNV)적림상료효급안전성.방법 림상병례치료전후대조연구.대2012년8월지2013년8월재천진시안과의원경림상검사학진적30례(30지안)CNV환자납입연구.술후수방3～10개월,평균7.2개월.채용국제표준시력표행최가교정시력(BCVA)화광학상간단층소묘(OCT)검사황반중심시망막후도(CRT).위편우통계분석,시력환산성최소분변각대수시력(logMAR).채용파리체강주사10mg/ml적Ranibizumab0.05ml(함Ranibizumab0.5mg),치료후1개월여발현CNV병조확대혹신발병조행재차주사치료.채용배대t검험대비분석치료전후시력、CRT적변화.결과 치료후1개월,평균CRT위(290.23±79.16)μm,교정시력평균위(0.62±0.31) logMAR,분별여치료전비교,차이균유통계학의의(t=6.11、4.79,P＜0.05).치료후3개월,평균CRT위(319.73±89.05) μm,교정시력평균위(0.61±0.34) logMAR,여치료전상비,차이균유통계학의의(t=7.69、5.16,P＜0.05).수차치료후1개월CRT하강폭도최대.수방중미발현안내감염등여파리체강주사상관적병발증.결론 파리체강주사Ranibizumab치료CNV안전유효,가이제고환자시력.OCT가통과CRT치변화초보지도치료,편우림상관찰.
Objective To observe the efficacy and safety of intravitreal injection of ranibizumab (Lucentis) for treatment of choroidal neovascularization (CNV).Methods Thirty eyes from 30 patients with CNV diagnosed by clinical examination were enrolled in this choroidal neovascularization study.Follow-up duration varied from 3 to 10 months (mean 7.2 months).The best-corrected visual acuity (BCVA) was obtained using the international standard visual acuity chart (converted into logMAR for statistical analysis).Central retinal thickness (CRT) was measured by optical coherence tomography (OCT).All of patients received intravitreal injection of ranibizumab (0.5mg,0.05ml) and repeated treatments after the one-month follow-up if needed.The changes of BCVA,CRT before and after treatment were observed.Results One month after first injection,the mean CRT was (290.23± 79.16) m,the mean logMAR was 0.62±0.31,which were both significant differences (t =6.11,4.79; P ＜0.05) compared with before treatment.Three months after treatment,the mean CRT was (319.73± 89.05) μm,the mean logMAR was 0.61±0.34,which were also significant differences (t =7.69,5.16; P ＜0.05).The greatest CRT reduction was observed in 1 month after the first injection.NO intravitreal injection-related side effects such as endophthalmitis were observed within the follow-up period.Conclusions Intravitreal injection of ranibizumab is effective and safe,may improve BCVA for treatment of CNV.Observed the changes of CRT may initial guide treatment,facilitate clinical observation.